West Chester Hospital
7700 University Drive, West Chester, OH 45069 · 123 Priced Procedures · 71% Patient Recommendation
Typical commercial prices here are +14% above the fair benchmark (1.14×) even after accounting for local nurse/doctor wages and patient complexity.
3-Star CMS clinical quality rating paired with 1.14× fair market pricing.
Aligned Regional Benchmark Peer
West Chester Hospital prices shoppable and inpatient services (1.3× to 1.3× Medicare, divergence 1.00×) in alignment with regional hospital peers (1.14× 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 1.03× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 13% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (65/100 safety score) with 71% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (17.5% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.1× markup over Medicare rates
- Commercial insurance median sits at 1.18× Fair BaseRate (1.3× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Even at low-cost facilities (1.14× 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 8.0× 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 West Chester Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 123 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $32,603 | 1.1× |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $20,000 | 1.0× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $19,867 | 1.0× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $18,244 | 1.0× |
| Total hip replacement CPT Code: 27130 | $13,763 | 1.0× |
| Total knee replacement CPT Code: 27447 | $13,763 | 1.0× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $8,576 | 1.0× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $8,312 | 1.4× |
| Breast lump removal CPT Code: 19120 | $4,788 | 1.2× |
| Inguinal hernia repair CPT Code: 49505 | $4,558 | 1.3× |
| Vaginal delivery (full package) CPT Code: 59400 | $4,210 | 1.6× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $4,231 | 1.3× |
| Bunion correction surgery CPT Code: 28296 | $4,165 | 1.2× |
| Cataract surgery with lens implant CPT Code: 66984 | $4,076 | 1.6× |
| Colonoscopy with biopsy CPT Code: 45380 | $2,057 | 1.6× |
| Trauma team activation HCPCS Code: G0390 | $1,705 | 1.2× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $1,643 | 1.7× |
| Upper endoscopy with biopsy CPT Code: 43239 | $1,602 | 1.6× |
| Injection procedure for pain management HCPCS Code: G0260 | $1,247 | 1.5× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $1,098 | 1.1× |
| Blood transfusion CPT Code: 36430 | $765 | 1.5× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $699 | 1.2× |
| Residential mental health treatment HCPCS Code: H2036 | $611 | 1.5× |
| Psychological testing by technician CPT Code: 96138 | $571 | 1.4× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $532 | 1.2× |
Audit a Bill or Quote at West Chester Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $13,670
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (17.5% of gross = $13,670).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask West Chester 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 ($78,247) is $47,472 above the denoised Fair BaseRate ($30,775) and 3.3× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (17.5% 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 West Chester Hospital. Prior administrative notices do not necessarily reflect current compliance status.
- 2026-03-19·administrative_or_closure
Met Requirements
Recorded
Source: CMS Hospital Care Compare (1,233 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 West Chester 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.