Mount Carmel East & West
6001 East Broad Street, Columbus, OH 43213 · 114 Priced Procedures · 67% Patient Recommendation
Typical commercial prices here are +40% above the fair benchmark (1.40×) even after accounting for local nurse/doctor wages and patient complexity.
3-Star CMS clinical quality rating paired with 1.40× fair market pricing.
Wide Procedure Spread · Upper-Quartile Skew Pricer
Mount Carmel East & West prices routine shoppable procedures at 2.2× Medicare (median 1.35× Fair BaseRate) while upper-quartile commercial rates jump +68% to 2.27× 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 0.97× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 35% of shoppable procedures (80/100 Cash Honesty)
- 2-Star CMS clinical rating with 67% patient recommendation (64/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (49.7% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (1.40× 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.
- Commercial insurance median sits at 1.35× Fair BaseRate (2.2× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 2.27×) jump +68% above the median procedure ratio (Q50 1.35×)
- Unnegotiated chargemaster list prices average 6.2× Medicare (25¢ 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 Mount Carmel East & West
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 114 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $67,615 | unverified |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $40,658 | 2.1× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $40,373 | unverified |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $36,901 | 2.1× |
| Total knee replacement CPT Code: 27447 | — | unverified |
| Total hip replacement CPT Code: 27130 | — | unverified |
| Inguinal hernia repair CPT Code: 49505 | $9,361 | 2.6× |
| Trauma team activation HCPCS Code: G0390 | $8,453 | 5.8× |
| Breast lump removal CPT Code: 19120 | $4,153 | 1.1× |
| C-section delivery (full package) CPT Code: 59510 | $3,477 | unverified |
| Upper endoscopy with biopsy CPT Code: 43239 | $3,262 | 3.3× |
| Colonoscopy with biopsy CPT Code: 45380 | $3,262 | 2.6× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $3,262 | unverified |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $2,921 | 0.4× |
| Injection procedure for pain management HCPCS Code: G0260 | $1,756 | 2.1× |
| Vaginal delivery (full package) CPT Code: 59400 | $1,304 | 0.5× |
| Blood transfusion CPT Code: 36430 | $1,183 | 2.4× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $1,148 | 2.2× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $1,126 | unverified |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $933 | 0.2× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $785 | 2.6× |
| MRI, lower back (no contrast) CPT Code: 72148 | $785 | 2.3× |
| MRI, brain (no contrast) CPT Code: 70551 | $785 | 2.3× |
| MRI, knee or other leg joint CPT Code: 73721 | $785 | 2.1× |
| Rabies immune globulin HCPCS Code: 90375 | $680 | 2.1× |
Audit a Bill or Quote at Mount Carmel East & West (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $80,586
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (49.7% of gross = $80,586).
Self-Pay Cash Rate ($138,404) Beats Your Bill
Mount Carmel East & West's published 45 CFR § 180 self-pay cash rate is $138,404 (vs. $67,615 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)
Your bill ($162,276) is $131,501 above the denoised Fair BaseRate ($30,775) and 6.9× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (49.7% 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)Source: CMS Hospital Care Compare (1,209 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 Mount Carmel East & West.
Notable Payer Contract Outliers (SVD Matrix Anomalies)
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.