How many shoppable procedure prices are published for Ohiohealth Shelby Hospital?

Ohiohealth Shelby Hospital in Shelby, OH currently has 104 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

What is Ohiohealth Shelby Hospital's CMS Care Compare overall star rating?

CMS Care Compare assigns Ohiohealth Shelby Hospital an overall hospital quality rating of 4 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Critical Access Hospital Voluntary non-profit - Private 21 Beds · rural Updated: 2026-04-01

Ohiohealth Shelby Hospital

199 West Main Street, Shelby, OH 44875 · 104 Priced Procedures

CMS Overall Rating 4 / 5 Stars

Near Fair BaseRate Benchmark

1.00×vs. Fair Market Price

Typical commercial prices here match the fair market benchmark (1.00×) after accounting for local nurse/doctor wages and patient complexity.

36/100 · Quarantined

36/100Self-Pay Cash Beats Insurance 0% of the Time

File Completeness85

Price Logic0

Peer Alignment0

Clean Billing0

Real Cash Discount100

High Quality · Fair Price

4-Star CMS clinical quality rating paired with 1.00× fair market pricing.

Behavioral Pricing FingerprintHigh Infusion / OR Multiples

Specialty Drug & Surgical Margin Engine

Ohiohealth Shelby Hospital concentrates commercial margin in outpatient surgical suites (4.5× Medicare) and specialty drug infusions (1.5× Medicare) relative to routine diagnostics (1.7×). Comparing freestanding ambulatory surgery centers or specialty pharmacy options before treatment yields substantial savings.

Regional Benchmark in OHU.S. National Reference Pool

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.78× 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 72% patient recommendation (65/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (18.7% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 4.5× markup over Medicare rates
Captive ER (1.6×) & laboratory (1.6×) services average 1.25× higher multiples than routine shoppable care (6.0×)
Upper-quartile procedures (Q75 1.28×) jump +28% above the median procedure ratio (Q50 1.00×)
Consolidated metro market (HHI 7,500) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

6.0× Medicare

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

Back-Door Captive & ER1.25× Divergence

7.5× Medicare

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

Quantile Tail Spread+28% Upper Tail

Q25 0.78× · Q50 1.00× · Q75 1.28×

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

6.0× MedicareWatchout

Outpatient Surgery & ORBack-Door Captive

4.5× MedicareWatchout

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.7× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.6× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.6× MedicareGood

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

1.5× MedicareGood

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

0% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 65/100Fair

Procedure Prices at Ohiohealth Shelby Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 104 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Trauma team activation HCPCS Code: `G0390`	$7,377	$7,377	$1,453	5.1×
Rabies immune globulin HCPCS Code: `90375`	$4,123	$4,123	$322	unverified
Sleep study (overnight, in lab) CPT Code: `95810`	$3,593	$3,593	$1,021	3.5×
MRI, knee or other leg joint CPT Code: `73721`	$3,402	$3,402	$369	9.2×
Colonoscopy with biopsy CPT Code: `45380`	$3,199	$3,199	$1,256	2.5×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,963	$2,963	$511	5.8×
Upper endoscopy with biopsy CPT Code: `43239`	$2,974	$2,974	$987	3.0×
MRI, lower back (no contrast) CPT Code: `72148`	$2,946	$2,946	$338	8.7×
Colonoscopy (diagnostic) CPT Code: `45378`	$2,876	$2,876	$981	2.9×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,826	$2,826	$448	6.3×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$2,560	$2,560	$303	8.4×
MRI, brain (no contrast) CPT Code: `70551`	$2,448	$2,448	$343	7.1×
Injection procedure for pain management HCPCS Code: `G0260`	$2,393	$2,393	$855	2.8×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$2,116	$2,116	$168	12.6×
CT scan, pelvis CPT Code: `72192`	$1,823	$1,823	$163	11.2×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,654	$1,654	$258	6.4×
CT scan, chest (no contrast) CPT Code: `71250`	$1,602	$1,602	$167	9.6×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,606	$1,606	$169	9.5×
CT scan, sinuses CPT Code: `70486`	$1,502	$1,502	$166	9.0×
CT scan, head (with contrast) CPT Code: `70460`	$1,370	$1,370	$242	5.7×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,347	$1,347	$583	2.3×
CT scan, head (no contrast) CPT Code: `70450`	$1,086	$1,086	$160	6.8×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$920	$920	$272	3.4×
Ultrasound, abdomen (complete) CPT Code: `76700`	$820	$820	$134	6.1×
Blood transfusion CPT Code: `36430`	$681	$681	$498	1.4×
Ultrasound, abdomen (limited) CPT Code: `76705`	$545	$545	$126	4.3×
Ultrasound, thyroid and neck CPT Code: `76536`	$551	$551	$132	4.2×
X-ray, shoulder CPT Code: `73030`	$518	$518	$92	5.6×
Ultrasound, pelvis CPT Code: `76856`	$543	$543	$130	4.2×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$522	$522	$148	3.5×
X-ray, foot CPT Code: `73630`	$494	$494	$92	5.4×
Neurobehavioral status check CPT Code: `96116`	$504	$504	$231	2.2×
X-ray, lower back CPT Code: `72110`	$471	$471	$112	4.2×
X-ray, hand CPT Code: `73130`	$441	$441	$93	4.7×
X-ray, hip CPT Code: `73502`	$397	$397	$93	4.3×
X-ray, ankle CPT Code: `73610`	$385	$385	$93	4.1×
X-ray, neck (cervical spine) CPT Code: `72040`	$376	$376	$93	4.0×
Hepatitis B immune globulin HCPCS Code: `90371`	$381	$381	$151	unverified
Group therapy session CPT Code: `90853`	$307	$307	$100	3.1×
Family therapy session CPT Code: `90847`	$314	$314	$173	1.8×
Psychotherapy session (60 minutes) CPT Code: `90837`	$314	$314	$181	1.7×
Speech therapy (language evaluation) CPT Code: `92507`	$273	$273	$86	3.2×
X-ray, chest (two views) CPT Code: `71046`	$237	$237	$93	2.5×
Psychotherapy session (45 minutes) CPT Code: `90834`	$248	$248	$166	1.5×
Psychiatric evaluation (first visit) CPT Code: `90791`	$248	$248	$185	1.3×
X-ray, chest (single view) CPT Code: `71045`	$215	$215	$92	2.3×
Behavioral health day program HCPCS Code: `H2012`	$161	$161	$100	1.6×
X-ray, pelvis CPT Code: `72170`	$174	$174	$110	1.6×
Screening mammogram (both breasts) CPT Code: `77067`	$172	$172	$123	1.4×
Breathing treatment (nebulizer) CPT Code: `94640`	$146	$146	$201	0.7×
Speech therapy (group session) CPT Code: `92508`	$108	$108	$27	4.0×
Physical therapy (manual therapy) CPT Code: `97140`	$105	$105	$34	3.1×
Physical therapy (gait training) CPT Code: `97116`	$101	$101	$33	3.1×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$103	$103	$35	2.9×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$101	$101	$40	2.5×
Occupational therapy (self-care training) CPT Code: `97535`	$94	$94	$38	2.5×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$90	$90	$38	2.4×
Physical therapy (functional capacity test) CPT Code: `97750`	$84	$84	$38	2.2×
Orthotic fitting and training CPT Code: `97760`	$105	$105	$51	2.1×
Prosthetic fitting and training CPT Code: `97761`	$89	$89	$45	2.0×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$97	$97	$64	1.5×
Hospital observation (per hour) HCPCS Code: `G0378`	$83	$83	$86	1.0×
Typhoid vaccine HCPCS Code: `90675`	$917	$917	$347	unverified
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$563	$563	$203	unverified
Pneumococcal vaccine HCPCS Code: `90732`	$377	$377	$140	unverified
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$298	$298	$111	unverified
Culture, bacterial CPT Code: `87070`	$149	$149	$9	16.6×
Culture, blood CPT Code: `87040`	$122	$122	$11	11.1×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$146	$146	$56	unverified
Blood test, ferritin (iron stores) CPT Code: `82728`	$103	$103	$14	7.4×
Blood test, amylase CPT Code: `82150`	$71	$71	$7	10.1×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$95	$95	$39	unverified
Blood test, lipase CPT Code: `83690`	$58	$58	$7	8.3×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$71	$71	$10	7.1×
Blood test, thyroid (TSH) CPT Code: `84443`	$69	$69	$18	3.8×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$78	$78	$27	2.9×
Flu vaccine (high dose) HCPCS Code: `90656`	$90	$90	$25	unverified
Hepatitis B vaccine HCPCS Code: `90744`	$88	$88	$37	unverified
Blood test, calcium CPT Code: `82310`	$36	$36	$5	7.2×
Blood test, magnesium CPT Code: `83735`	$48	$48	$7	6.9×
Blood test, clotting time (PTT) CPT Code: `85730`	$38	$38	$6	6.3×
Blood test, basic metabolic panel CPT Code: `80048`	$51	$51	$9	5.7×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$59	$59	$11	5.4×
Electrical stimulation therapy HCPCS Code: `G0283`	$62	$62	$14	4.4×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$55	$55	$14	3.9×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$23	$23	$5	4.6×
Hepatitis C antibody test CPT Code: `86803`	$47	$47	$15	3.1×
Blood test, vitamin B12 CPT Code: `82607`	$47	$47	$16	2.9×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$54	$54	$20	2.7×
Blood test, complete blood count (CBC) CPT Code: `85025`	$23	$23	$8	2.9×
Blood test, PSA (prostate screen) CPT Code: `84153`	$45	$45	$19	2.4×
Blood test, vitamin D CPT Code: `82306`	$59	$59	$31	1.9×
Blood antibody screen CPT Code: `86850`	$46	$46	$46	1.0×
Flu vaccine injection HCPCS Code: `G0008`	$36	$36	$48	0.8×
Pneumonia vaccine injection HCPCS Code: `G0009`	$36	$36	$49	0.7×
Colorectal cancer screening HCPCS Code: `G0010`	$36	$36	$49	0.7×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$10	$10	$3	3.3×
Blood test, liver function panel CPT Code: `80076`	$24	$24	$9	2.7×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$10	$10	$4	2.5×
Blood test, hemoglobin CPT Code: `85018`	$7	$7	$3	2.3×
Blood test, glucose (blood sugar) CPT Code: `82947`	$9	$9	$4	2.3×
Blood test, creatinine (kidney) CPT Code: `82565`	$9	$9	$5	1.8×
Blood test, potassium CPT Code: `84132`	$9	$9	$5	1.8×
Blood test, sodium CPT Code: `84295`	$9	$9	$5	1.8×

Showing top 25 high-impact procedures of 104 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 18.7%

Audit a Bill or Quote at Ohiohealth Shelby Hospital (Zero PHI Required)

CMS CCN: 361324

CPT G0390

Select Procedure to Audit:

Fair BaseRate™ $1,453

Medicare Rate $1,362

Self-Pay Cash $7,377

Insurer Median $7,377

1. Amount on Your Bill or Quote ($) Pre-filled with Ohiohealth Shelby Hospital’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: $2,127 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $2,127

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (18.7% of gross = $2,127).

Step 2 · Cash vs. Insurance Arbitrage Save $3,972 Paying Cash

Self-Pay Cash Rate ($7,377) Beats Your Bill

Ohiohealth Shelby Hospital's published 45 CFR § 180 self-pay cash rate is $7,377 (vs. $7,377 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$9,896 Above Fair BaseRate

Negotiate Toward $1,453 Fair BaseRate ($1,362 Medicare)

Your bill ($11,349) is $9,896 above the denoised Fair BaseRate ($1,453) and 8.3× the $1,362 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)

EIN: 340714456

Filing Period: 199103

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: prospective_medicare_median

Hospital-Specific CMS HCRIS Benchmark (18.7% 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.

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 Overall4/5 Stars (4/5)

Safety Composite65/100

Left ER Before Seen0%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

C. diff Hospital-Onset Infectionsame

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Ohiohealth Shelby Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2025-04-10·administrative_or_closure
Closure Notice
Recorded
2025-02-25·cap_corrective_action
CAP Request
Recorded
2024-11-21·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare. 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 Value & Quality Leader

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Ohiohealth Shelby Hospital.

Price Index: 1.00× regional baseline

Quality: 70/100 CMS composite

Median Household Income$57,649U.S. Census ACS

Local Uninsured Share6.9%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 36/100 · Quarantined CMS CCN 361324 EIN 340714456

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 361324) ↗ Verify IRS Form 990 (EIN 340714456) ↗ CMS HCRIS Cost Reports ↗

Published MRF File340714456_ohiohealth-shelby-hospital_standardcharges.json

Publication / Vintage2026-04-01 · 7.39 MB

Validated Rate Rows0 (CMS v3.0.0)

File Integrity Digest6d480365118c9833ae64…

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.

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