Miami Valley Hospital
One Wyoming Street, Dayton, OH 45409 · 120 Priced Procedures · 59% Patient Recommendation
Typical commercial prices here are +26% above the fair benchmark (1.26×) even after accounting for local nurse/doctor wages and patient complexity.
2-Star CMS clinical quality rating paired with 1.26× fair market pricing.
Wide Procedure Spread · Upper-Quartile Skew Pricer
Miami Valley Hospital prices routine shoppable procedures at 1.6× Medicare (median 1.18× Fair BaseRate) while upper-quartile commercial rates jump +42% to 1.68× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 1.03× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 1% of shoppable procedures (25/100 Cash Honesty)
- CMS clinical safety score (59/100 safety score) with 59% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (12.5% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 2.0× markup over Medicare rates
- Commercial insurance median sits at 1.18× Fair BaseRate (1.6× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 1.68×) jump +42% above the median procedure ratio (Q50 1.18×)
- Consolidated metro market (HHI 2,470) limits in-network hospital competition (Moderately Concentrated (1,500–2,500))
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 Miami Valley Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 120 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $62,821 | unverified |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $43,857 | unverified |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $42,141 | unverified |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $36,830 | unverified |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $17,440 | unverified |
| Total hip replacement CPT Code: 27130 | $16,745 | 1.2× |
| Total knee replacement CPT Code: 27447 | $16,745 | 1.2× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $13,382 | 2.2× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $7,853 | 2.3× |
| Bunion correction surgery CPT Code: 28296 | $7,853 | 2.3× |
| Inguinal hernia repair CPT Code: 49505 | $7,853 | 2.2× |
| Cataract surgery with lens implant CPT Code: 66984 | $6,522 | 2.6× |
| Breast lump removal CPT Code: 19120 | $6,522 | 1.7× |
| Upper endoscopy with biopsy CPT Code: 43239 | $4,951 | unverified |
| Colonoscopy (diagnostic) CPT Code: 45378 | $4,951 | unverified |
| Colonoscopy with biopsy CPT Code: 45380 | $4,951 | unverified |
| Sleep study (overnight, in lab) CPT Code: 95810 | $1,593 | 1.6× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $1,014 | 1.7× |
| Psychological testing by technician CPT Code: 96138 | $829 | 2.1× |
| Hospital observation (per hour) HCPCS Code: G0378 | $641 | 7.5× |
| Blood transfusion CPT Code: 36430 | $523 | unverified |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $443 | 1.6× |
| Rabies immune globulin HCPCS Code: 90375 | $440 | 1.4× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $436 | 1.0× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $436 | 0.9× |
Audit a Bill or Quote at Miami Valley Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $18,891
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (12.5% of gross = $18,891).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Miami Valley 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 $30,775 Fair BaseRate ($23,504 Medicare)
Your bill ($150,770) is $119,995 above the denoised Fair BaseRate ($30,775) and 6.4× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (12.5% 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 Miami Valley Hospital. Prior administrative notices do not necessarily reflect current compliance status.
- 2025-06-18·administrative_or_closure
Met Requirements
Recorded - 2023-08-10·administrative_or_closure
Met Requirements
Recorded - 2022-07-15·administrative_or_closure
Closure Notice
Recorded - 2022-06-29·cap_corrective_action
CAP Request
Recorded - 2021-09-29·warning_notice
Warning Notice
Recorded
Source: CMS Hospital Care Compare (424 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 Miami Valley 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.