How many shoppable procedure prices are published for Mount Carmel St Ann's?

Mount Carmel St Ann's in Westerville, OH currently has 115 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Mount Carmel St Ann's's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Mount Carmel St Ann's's median negotiated commercial rate is 1.4× the regionally adjusted fair BaseRate benchmark.

What is Mount Carmel St Ann's's CMS Care Compare overall star rating?

CMS Care Compare assigns Mount Carmel St Ann's an overall hospital quality rating of 3 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 270 Beds · urban Updated: 2026-03-31

Mount Carmel St Ann's

500 South Cleveland Avenue, Westerville, OH 43081 · 115 Priced Procedures · 67% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

Above Fair Market · Negotiate

1.39×vs. Fair Market Price

Typical commercial prices here are +39% above the fair benchmark (1.39×) even after accounting for local nurse/doctor wages and patient complexity.

59/100 · Caution

59/100Self-Pay Cash Beats Insurance 32% of the Time

File Completeness56

Price Logic39

Peer Alignment73

Clean Billing65

Real Cash Discount71

High Price · Lower Safety

2-Star CMS clinical quality rating paired with 1.39× fair market pricing.

Behavioral Pricing FingerprintUpper-Quartile Spread · +64% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Mount Carmel St Ann's prices routine shoppable procedures at 2.3× Medicare (median 1.38× Fair BaseRate) while upper-quartile commercial rates jump +64% to 2.27× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#115 of 137 in OH · 83rd State Percentile#2,434 of 3,385 in U.S. · 71st National Percentile

Advantage

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 32% of shoppable procedures (71/100 Cash Honesty)
CMS clinical safety score (60/100 safety score) with 67% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (62.4% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.39× 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 1.38× Fair BaseRate (2.3× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 2.27×) jump +64% above the median procedure ratio (Q50 1.38×)
Unnegotiated chargemaster list prices average 6.4× Medicare (28¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

2.3× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER0.61× Divergence

1.4× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+64% Upper Tail

Q25 0.97× · Q50 1.38× · Q75 2.27×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

2.3× MedicareFair

Outpatient Surgery & ORBack-Door Captive

0.8× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

3.3× MedicareElevated

Back-Door Captive ER VisitsBack-Door Captive

3.3× MedicareElevated

Inpatient Lab & PathologyBack-Door Captive

3.0× MedicareFair

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

1.5× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

32% Cash Edge · 71/100Fair

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 60/100Elevated

Procedure Prices at Mount Carmel St Ann's

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 115 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	$91,645	$67,615	$30,775	unverified
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$47,367	$40,658	$19,087	unverified
Heart stent placement (inpatient stay) MS-DRG Code: `322`	$61,493	$36,901	$17,936	2.1×
Total hip replacement CPT Code: `27130`	$50,445	$29,199	$13,413	unverified
Total knee replacement CPT Code: `27447`	$66,937	$29,199	$13,523	unverified
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$21,830	$16,318	$8,223	2.0×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$57,693	$13,285	$19,432	0.7×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$36,438	$12,174	$3,372	unverified
Inguinal hernia repair CPT Code: `49505`	$21,607	$7,215	$3,629	2.0×
Bunion correction surgery CPT Code: `28296`	$26,334	$5,933	$3,446	1.7×
Breast lump removal CPT Code: `19120`	—	—	$3,875	—
Upper endoscopy with biopsy CPT Code: `43239`	$3,870	$3,698	$987	unverified
C-section delivery (full package) CPT Code: `59510`	$3,477	$3,477	$2,975	unverified
Sleep study (overnight, in lab) CPT Code: `95810`	$2,109	$1,865	$1,021	1.8×
Injection procedure for pain management HCPCS Code: `G0260`	$2,993	$1,756	$855	2.1×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$1,451	$1,451	$6,109	0.2×
Vaginal delivery (full package) CPT Code: `59400`	—	$1,304	$2,680	0.5×
Colonoscopy with biopsy CPT Code: `45380`	—	—	$1,256	—
Blood transfusion CPT Code: `36430`	$1,918	$1,183	$498	2.4×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,022	$1,197	$511	2.3×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,118	$1,126	$448	2.5×
Colonoscopy (diagnostic) CPT Code: `45378`	—	—	$981	—
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,851	$819	$303	2.7×
Rabies immune globulin HCPCS Code: `90375`	$3,760	$840	$322	2.6×
MRI, lower back (no contrast) CPT Code: `72148`	$1,236	$819	$338	2.4×
MRI, brain (no contrast) CPT Code: `70551`	$1,344	$819	$343	2.4×
MRI, knee or other leg joint CPT Code: `73721`	$1,543	$819	$369	2.2×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$81	$632	$272	2.3×
CT scan, head (with contrast) CPT Code: `70460`	$1,005	$631	$242	unverified
CT scan, head (with and without contrast) CPT Code: `70470`	$1,056	$631	$258	unverified
Ultrasound, pelvis CPT Code: `76856`	—	$376	$130	2.9×
CT scan, head (no contrast) CPT Code: `70450`	$978	$376	$160	2.4×
CT scan, pelvis CPT Code: `72192`	$788	$376	$163	2.3×
CT scan, sinuses CPT Code: `70486`	$888	$376	$166	2.3×
CT scan, chest (no contrast) CPT Code: `71250`	$1,019	$376	$167	2.3×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,321	$376	$168	2.2×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,957	$376	$169	2.2×
X-ray, pelvis CPT Code: `72170`	—	$376	$110	unverified
Ultrasound, thyroid and neck CPT Code: `76536`	$589	$376	$132	unverified
Ultrasound, abdomen (complete) CPT Code: `76700`	$578	$376	$134	unverified
Ultrasound, abdomen (limited) CPT Code: `76705`	$556	$376	$126	unverified
X-ray, chest (single view) CPT Code: `71045`	—	$306	$92	3.3×
X-ray, hip CPT Code: `73502`	$327	$245	$93	2.6×
X-ray, lower back CPT Code: `72110`	$377	$261	$112	unverified
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	—	$212	$64	3.3×
Breathing treatment (nebulizer) CPT Code: `94640`	$233	$233	$201	1.2×
Hospital observation (per hour) HCPCS Code: `G0378`	$234	$234	$86	unverified
X-ray, ankle CPT Code: `73610`	$506	$193	$93	2.1×
X-ray, shoulder CPT Code: `73030`	$323	$190	$92	2.1×
X-ray, foot CPT Code: `73630`	$350	$190	$92	2.1×
X-ray, hand CPT Code: `73130`	$300	$191	$93	2.1×
X-ray, chest (two views) CPT Code: `71046`	$442	$190	$93	2.0×
Hepatitis B immune globulin HCPCS Code: `90371`	$208	$207	$151	1.4×
Psychiatric evaluation (first visit) CPT Code: `90791`	$273	$209	$185	1.1×
X-ray, neck (cervical spine) CPT Code: `72040`	$250	$196	$93	unverified
Office visit, established patient (30-39 min) CPT Code: `99214`	$282	$142	$123	1.2×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$277	$131	$148	0.9×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$155	$155	$583	0.3×
Speech therapy (language evaluation) CPT Code: `92507`	$146	$96	$86	1.1×
Office visit, established patient (20-29 min) CPT Code: `99213`	$149	$85	$87	1.0×
Screening mammogram (both breasts) CPT Code: `77067`	$117	$108	$123	0.9×
New patient office visit (30-44 min) CPT Code: `99203`	$218	$91	$110	0.8×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$288	$204	$203	1.0×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$127	$102	$111	0.9×
Pneumococcal vaccine HCPCS Code: `90732`	$123	$123	$140	0.9×
Blood antibody screen CPT Code: `86850`	$89	$101	$46	unverified
Flu vaccine (high dose) HCPCS Code: `90656`	$40	$35	$25	1.4×
Hepatitis B vaccine HCPCS Code: `90744`	$58	$50	$37	1.4×
Flu vaccine injection HCPCS Code: `G0008`	$55	$55	$48	1.1×
Pneumonia vaccine injection HCPCS Code: `G0009`	$55	$55	$49	1.1×
Colorectal cancer screening HCPCS Code: `G0010`	$55	$55	$49	1.1×
Orthotic fitting and training CPT Code: `97760`	$99	$57	$51	1.1×
Speech therapy (group session) CPT Code: `92508`	$77	$30	$27	1.1×
Prosthetic fitting and training CPT Code: `97761`	$91	$50	$45	1.1×
Physical therapy (functional capacity test) CPT Code: `97750`	$100	$42	$38	1.1×
Occupational therapy (therapeutic activities) CPT Code: `97530`	—	$44	$40	1.1×
Physical therapy (gait training) CPT Code: `97116`	$94	$36	$33	1.1×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	—	$41	$38	1.1×
Occupational therapy (self-care training) CPT Code: `97535`	$89	$40	$38	1.1×
Physical therapy (manual therapy) CPT Code: `97140`	$99	$35	$34	1.0×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$85	$36	$35	1.0×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$77	$47	$56	0.8×
Blood test, ferritin (iron stores) CPT Code: `82728`	$76	$14	$14	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	—	$4	$4	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$39	$10	$10	1.0×
Blood test, lipase CPT Code: `83690`	$46	$7	$7	1.0×
Blood test, magnesium CPT Code: `83735`	$84	$7	$7	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$31	$8	$8	1.0×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$47	$19	$20	0.9×
Electrical stimulation therapy HCPCS Code: `G0283`	$74	$12	$14	0.9×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$55	$32	$39	0.8×
Blood test, clotting time (PTT) CPT Code: `85730`	$41	$6	$6	1.0×
Blood test, vitamin D CPT Code: `82306`	$73	$30	$31	1.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$77	$18	$19	0.9×
Blood test, thyroid (TSH) CPT Code: `84443`	$67	$17	$18	0.9×
Blood test, vitamin B12 CPT Code: `82607`	$88	$15	$16	0.9×
Hepatitis C antibody test CPT Code: `86803`	$29	$14	$15	0.9×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$54	$13	$14	0.9×
Blood test, liver function panel CPT Code: `80076`	$33	$8	$9	0.9×
Blood test, amylase CPT Code: `82150`	$39	$6	$7	0.9×
Extended office visit (prolonged) HCPCS Code: `G2212`	$70	$27	$33	0.8×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$20	$4	$5	0.8×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$32	$14	$25	0.6×
Diagnostic procedure preparation HCPCS Code: `G0279`	$47	$15	$35	0.4×
Blood test, basic metabolic panel CPT Code: `80048`	—	—	$9	—
Blood test, comprehensive metabolic panel CPT Code: `80053`	—	—	$11	unverified
Urinalysis (automated, with microscopy) CPT Code: `81001`	—	—	$3	—
Blood test, calcium CPT Code: `82310`	—	—	$5	unverified
Blood test, creatinine (kidney) CPT Code: `82565`	—	—	$5	unverified
Blood test, potassium CPT Code: `84132`	—	—	$5	unverified
Blood test, sodium CPT Code: `84295`	—	—	$5	—
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	—	—	$4	unverified
Blood test, hemoglobin CPT Code: `85018`	—	—	$3	—
Culture, blood CPT Code: `87040`	—	—	$11	unverified
Culture, bacterial CPT Code: `87070`	—	—	$9	unverified

Showing top 25 high-impact procedures of 115 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 62.4%

Audit a Bill or Quote at Mount Carmel St Ann's (Zero PHI Required)

CMS CCN: 360012

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash $91,645

Insurer Median $67,615

1. Amount on Your Bill or Quote ($) Pre-filled with Mount Carmel St Ann's’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $101,179 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $101,179

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (62.4% of gross = $101,179).

Step 2 · Cash vs. Insurance Arbitrage Save $70,631 Paying Cash

Self-Pay Cash Rate ($91,645) Beats Your Bill

Mount Carmel St Ann's's published 45 CFR § 180 self-pay cash rate is $91,645 (vs. $67,615 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$131,501 Above Fair BaseRate

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.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (62.4% 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.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall2/5 Stars (2/5)

Safety Composite60/100

Would Recommend67%

Rated 9 or 10 (HCAHPS)66%

Median ER Wait175 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate3.3%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionsame

C. diff Hospital-Onset Infectionbetter

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Mount Carmel St Ann's. Prior administrative notices do not necessarily reflect current compliance status.

2025-03-26·administrative_or_closure
Met Requirements
Recorded
2023-06-05·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare (601 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Quality & Price Benchmark

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Mount Carmel St Ann's.

Price Index: 0.73× regional baseline

Quality: 49/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Dentaquest

-58.1%

National Healthcare Solutions

-57.1%

UnitedHealthcare

+69.3%

CareSource

+85.3%

Sentara

+94.1%

Bccp

+118.1%

Median Household Income$73,795U.S. Census ACS

Local Uninsured Share8.4%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 59/100 · Caution CMS CCN 360012

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 360012) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-03-31

Validated Rate Rows39,995 (CMS v3.0.0)

File Integrity DigestVerified · CCN 360012

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.

Submit MRF Update Correction Policy