Mercy Health - West Hospital
3300 Mercy Health Blvd, Cincinnati, OH 45211 · 92 Priced Procedures · 69% Patient Recommendation
Typical commercial prices here are +11% above the fair benchmark (1.11×) even after accounting for local nurse/doctor wages and patient complexity.
3-Star CMS clinical quality rating paired with 1.11× fair market pricing.
Aligned Regional Benchmark Peer
Mercy Health - West Hospital prices shoppable and inpatient services (1.2× to 1.6× Medicare, divergence 1.33×) in alignment with regional hospital peers (1.11× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.94× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 0% of shoppable procedures (99/100 Cash Honesty)
- 4-Star CMS clinical rating with 69% patient recommendation (69/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (13.4% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.5× markup over Medicare rates
- Captive ER (1.7×) & laboratory (1.7×) services average 1.33× higher multiples than routine shoppable care (1.2×)
- Even at low-cost facilities (1.11× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
- Unnegotiated chargemaster list prices average 8.3× Medicare (14¢ true HCRIS cost per $1 gross)
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Mercy Health - West Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 92 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $21,473 | 1.1× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $21,331 | 1.1× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $19,604 | 1.1× |
| Total hip replacement CPT Code: 27130 | $12,729 | 0.9× |
| Total knee replacement CPT Code: 27447 | $12,729 | 0.9× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $9,366 | 1.1× |
| Rabies immune globulin HCPCS Code: 90375 | $8,819 | 27.4× |
| Bunion correction surgery CPT Code: 28296 | $7,194 | 2.1× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $5,994 | 1.0× |
| Breast lump removal CPT Code: 19120 | $3,882 | 1.0× |
| Inguinal hernia repair CPT Code: 49505 | $3,550 | 1.0× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $3,244 | 1.0× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $2,012 | 4.5× |
| Upper endoscopy with biopsy CPT Code: 43239 | $1,902 | 1.9× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $1,609 | 5.3× |
| CT scan, head (with contrast) CPT Code: 70460 | $1,214 | 5.0× |
| Blood transfusion CPT Code: 36430 | $1,186 | 2.4× |
| Colonoscopy with biopsy CPT Code: 45380 | $1,186 | 0.9× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $1,141 | 4.4× |
| CT scan, pelvis CPT Code: 72192 | $926 | 5.7× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $922 | 0.9× |
| CT scan, sinuses CPT Code: 70486 | $893 | 5.4× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $827 | 4.9× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $782 | 4.6× |
| CT scan, head (no contrast) CPT Code: 70450 | $733 | 4.6× |
Audit a Bill or Quote at Mercy Health - West Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $6,926
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (13.4% of gross = $6,926).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Mercy Health - West Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $19,087 Fair BaseRate ($14,117 Medicare)
Your bill ($51,535) is $32,448 above the denoised Fair BaseRate ($19,087) and 3.7× the $14,117 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (13.4% of gross charges)
Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Mercy Health - West Hospital. Prior administrative notices do not necessarily reflect current compliance status.
- 2025-04-02·administrative_or_closure
Met Requirements
Recorded
Source: CMS Hospital Care Compare (966 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Mercy Health - West Hospital.
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.