How many shoppable procedure prices are published for Duncan Regional Hospital, Inc?

Duncan Regional Hospital, Inc in Duncan, OK currently has 129 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Duncan Regional Hospital, Inc's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Duncan Regional Hospital, Inc's median negotiated commercial rate is 2.5× the regionally adjusted fair BaseRate benchmark.

What is Duncan Regional Hospital, Inc's CMS Care Compare overall star rating?

CMS Care Compare assigns Duncan Regional Hospital, Inc 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 86 Beds · rural Updated: 2026-03-14

Duncan Regional Hospital, Inc

1407 Whisenant Drive, Duncan, OK 73533 · 129 Priced Procedures · 64% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

High Markup · Shop Alternatives

2.49×vs. Fair Market Price

Typical commercial prices here are +149% above the fair benchmark (2.49×) even after accounting for local nurse/doctor wages and patient complexity.

72/100 · Corroborated

72/100Self-Pay Cash Beats Insurance 70% of the Time

File Completeness66

Price Logic55

Peer Alignment73

Clean Billing73

Real Cash Discount100

High-Markup · Check Safety

3-Star CMS clinical quality rating paired with 2.49× fair market pricing.

Behavioral Pricing FingerprintUpper-Quartile Spread · +21% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Duncan Regional Hospital, Inc prices routine shoppable procedures at 3.2× Medicare (median 2.50× Fair BaseRate) while upper-quartile commercial rates jump +21% to 3.02× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#75 of 81 in OK · 91st State Percentile#3,247 of 3,385 in U.S. · 95th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.52× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 70% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (64/100 safety score) with 64% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (65.0% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.1× markup over Medicare rates
Commercial insurance median sits at 2.50× Fair BaseRate (3.2× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 3.02×) jump +21% above the median procedure ratio (Q50 2.50×)
Consolidated metro market (HHI 10,000) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

3.2× Medicare

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

Back-Door Captive & ER0.56× Divergence

1.8× Medicare

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

Quantile Tail Spread+21% Upper Tail

Q25 1.52× · Q50 2.50× · Q75 3.02×

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

3.2× MedicareElevated

Outpatient Surgery & ORBack-Door Captive

1.1× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

4.8× MedicareWatchout

Back-Door Captive ER VisitsBack-Door Captive

4.6× MedicareWatchout

Inpatient Lab & PathologyBack-Door Captive

5.9× MedicareWatchout

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

1.3× MedicareGood

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

70% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 64/100Elevated

Procedure Prices at Duncan Regional Hospital, Inc

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 129 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Total hip replacement CPT Code: `27130`	$26,233	$35,662	$13,413	unverified
Total knee replacement CPT Code: `27447`	$26,233	$35,662	$13,523	unverified
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	$49,460	$34,622	$30,775	1.1×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$30,220	$30,757	$19,432	1.6×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$31,447	$30,244	$19,087	1.6×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	$28,997	$20,298	$17,936	1.1×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$11,895	$14,887	$6,109	2.4×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$12,506	$12,375	$8,223	1.5×
Bunion correction surgery CPT Code: `28296`	$6,615	$12,292	$3,446	unverified
Inguinal hernia repair CPT Code: `49505`	$7,195	$10,711	$3,629	3.0×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$6,615	$10,646	$3,372	3.2×
Cataract surgery with lens implant CPT Code: `66984`	$4,650	$7,341	$2,540	2.9×
Breast lump removal CPT Code: `19120`	$7,807	$5,893	$3,875	1.5×
Sleep study (overnight, in lab) CPT Code: `95810`	$2,074	$3,313	$1,021	3.2×
Colonoscopy (diagnostic) CPT Code: `45378`	$1,859	$2,758	$981	2.8×
Colonoscopy with biopsy CPT Code: `45380`	$2,404	$2,758	$1,256	2.2×
Trauma team activation HCPCS Code: `G0390`	$2,698	$2,394	$1,453	1.6×
Upper endoscopy with biopsy CPT Code: `43239`	$1,912	$1,912	$987	1.9×
MRI, brain (no contrast) CPT Code: `70551`	$493	$1,636	$343	4.8×
MRI, brain (with and without contrast) CPT Code: `70553`	$728	$1,636	$511	3.2×
Injection procedure for pain management HCPCS Code: `G0260`	$1,412	$1,475	$855	1.7×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$493	$1,193	$303	3.9×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$728	$1,193	$448	2.7×
CT scan, pelvis CPT Code: `72192`	$217	$1,193	$163	unverified
MRI, knee or other leg joint CPT Code: `73721`	$493	$1,042	$369	2.8×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,118	$1,036	$583	1.8×
CT scan, sinuses CPT Code: `70486`	$217	$971	$166	5.8×
CT scan, chest (no contrast) CPT Code: `71250`	$217	$971	$167	5.8×
MRI, lower back (no contrast) CPT Code: `72148`	$493	$923	$338	2.7×
Behavioral health day treatment HCPCS Code: `H0010`	—	$870	$343	2.5×
Behavioral health residential care HCPCS Code: `H0011`	—	$870	$364	2.4×
Blood transfusion CPT Code: `36430`	$891	$891	$498	unverified
CT scan, lower back (lumbar spine) CPT Code: `72131`	$217	$807	$168	4.8×
CT scan, neck (cervical spine) CPT Code: `72125`	$217	$807	$169	4.8×
Mental health services (therapy) HCPCS Code: `H0032`	—	$757	$65	11.6×
Behavioral health counseling (per session) HCPCS Code: `H0008`	—	$757	$257	2.9×
Behavioral health counseling (group) HCPCS Code: `H0009`	—	$757	$269	2.8×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$493	$724	$272	2.7×
Psychological testing by technician CPT Code: `96138`	$814	$722	$395	1.8×
Diagnostic mammogram (both breasts) CPT Code: `77066`	—	$629	$148	unverified
Neurobehavioral status check CPT Code: `96116`	$635	$563	$231	2.4×
Rabies immune globulin HCPCS Code: `90375`	$572	$572	$322	1.8×
Care planning with family CPT Code: `90887`	—	$483	$107	4.5×
Ultrasound, abdomen (limited) CPT Code: `76705`	$217	$436	$126	3.5×
Ultrasound, pelvis CPT Code: `76856`	$217	$436	$130	3.4×
Ultrasound, thyroid and neck CPT Code: `76536`	$217	$436	$132	3.3×
Ultrasound, abdomen (complete) CPT Code: `76700`	$217	$436	$134	3.3×
CT scan, head (no contrast) CPT Code: `70450`	$217	$461	$160	2.9×
CT scan, head (with contrast) CPT Code: `70460`	$363	$461	$242	1.9×
CT scan, head (with and without contrast) CPT Code: `70470`	$363	$461	$258	1.8×
Mental health services (assessment) HCPCS Code: `H0031`	—	$392	$140	2.8×
Behavioral health assessment HCPCS Code: `H0001`	—	$392	$157	2.5×
Residential mental health treatment HCPCS Code: `H2036`	—	$365	$406	0.9×
Family therapy session CPT Code: `90847`	$328	$328	$173	1.9×
Group therapy session CPT Code: `90853`	$189	$302	$100	3.0×
Psychotherapy session (45 minutes) CPT Code: `90834`	—	$291	$166	1.8×
Psychotherapy session (60 minutes) CPT Code: `90837`	$328	$291	$181	1.6×
Psychological testing evaluation CPT Code: `96136`	$263	$233	$128	1.8×
Psychiatric evaluation (first visit) CPT Code: `90791`	—	—	$185	—
Breathing treatment (nebulizer) CPT Code: `94640`	—	—	$201	unverified
Physical therapy (gait training) CPT Code: `97116`	—	$106	$33	3.2×
Physical therapy (manual therapy) CPT Code: `97140`	—	$106	$34	3.1×
Physical therapy (therapeutic exercise) CPT Code: `97110`	—	$106	$35	3.0×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	—	$106	$38	2.8×
Physical therapy (functional capacity test) CPT Code: `97750`	—	$106	$38	2.8×
Occupational therapy (therapeutic activities) CPT Code: `97530`	—	$106	$40	2.6×
Prosthetic fitting and training CPT Code: `97761`	—	$106	$45	2.4×
Orthotic fitting and training CPT Code: `97760`	—	$106	$51	2.1×
Screening mammogram (both breasts) CPT Code: `77067`	—	—	$123	—
New patient office visit (30-44 min) CPT Code: `99203`	—	—	$110	—
Office visit, established patient (30-39 min) CPT Code: `99214`	—	—	$123	—
X-ray, chest (single view) CPT Code: `71045`	$180	$85	$92	0.9×
X-ray, shoulder CPT Code: `73030`	$180	$85	$92	0.9×
X-ray, foot CPT Code: `73630`	$180	$85	$92	0.9×
X-ray, chest (two views) CPT Code: `71046`	$180	$85	$93	0.9×
X-ray, neck (cervical spine) CPT Code: `72040`	$180	$85	$93	0.9×
X-ray, hand CPT Code: `73130`	$180	$85	$93	0.9×
X-ray, hip CPT Code: `73502`	$180	$85	$93	0.9×
X-ray, ankle CPT Code: `73610`	$180	$85	$93	0.9×
X-ray, pelvis CPT Code: `72170`	$217	$85	$110	0.8×
X-ray, lower back CPT Code: `72110`	$217	$85	$112	0.8×
Speech therapy (language evaluation) CPT Code: `92507`	—	—	$86	—
Office visit, established patient (20-29 min) CPT Code: `99213`	—	—	$87	—
Typhoid vaccine HCPCS Code: `90675`	$668	$668	$347	unverified
Drug screening test HCPCS Code: `G0480`	—	$117	$116	1.0×
Colorectal cancer screening HCPCS Code: `G0010`	$94	$83	$49	1.7×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$57	$57	$27	2.1×
Blood test, PSA (prostate screen) CPT Code: `84153`	$39	$39	$19	2.1×
Blood test, vitamin D CPT Code: `82306`	$63	$63	$31	2.0×
Hepatitis B immune globulin HCPCS Code: `90371`	$298	$71	$151	0.5×
Blood test, clotting time (PTT) CPT Code: `85730`	$13	$15	$6	2.5×
Blood test, complete blood count (CBC) CPT Code: `85025`	$17	$17	$8	2.1×
Hepatitis C antibody test CPT Code: `86803`	$31	$31	$15	2.1×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$41	$41	$20	2.0×
Blood test, thyroid (TSH) CPT Code: `84443`	$36	$36	$18	2.0×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$37	$25	1.5×
Hospital observation (per hour) HCPCS Code: `G0378`	—	$62	$86	0.7×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$7	$7	$3	2.3×
Blood test, calcium CPT Code: `82310`	$11	$11	$5	2.2×
Blood test, creatinine (kidney) CPT Code: `82565`	$11	$11	$5	2.2×
Blood test, lipase CPT Code: `83690`	$15	$15	$7	2.1×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$21	$21	$10	2.1×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$23	$23	$11	2.1×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$29	$29	$14	2.1×
Blood test, ferritin (iron stores) CPT Code: `82728`	$29	$29	$14	2.1×
Blood test, basic metabolic panel CPT Code: `80048`	$18	$18	$9	2.0×
Blood test, liver function panel CPT Code: `80076`	$18	$18	$9	2.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$8	$8	$4	2.0×
Blood test, magnesium CPT Code: `83735`	$14	$14	$7	2.0×
Blood test, potassium CPT Code: `84132`	$10	$10	$5	2.0×
Blood test, sodium CPT Code: `84295`	$10	$10	$5	2.0×
Blood test, amylase CPT Code: `82150`	$14	$14	$7	unverified
Blood test, vitamin B12 CPT Code: `82607`	$32	$32	$16	unverified
Hepatitis B vaccine HCPCS Code: `90744`	—	—	$37	—
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$8	$8	$4	2.0×
Culture, bacterial CPT Code: `87070`	$18	$18	$9	2.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$9	$9	$5	1.8×
Blood antibody screen CPT Code: `86850`	$109	$34	$46	0.7×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$121	$37	$64	0.6×
Blood test, hemoglobin CPT Code: `85018`	$5	$5	$3	unverified
Culture, blood CPT Code: `87040`	$22	$22	$11	unverified
Flu vaccine (high dose) HCPCS Code: `90656`	—	—	$25	—
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	—	—	$39	—
Speech therapy (group session) CPT Code: `92508`	—	—	$27	unverified
Occupational therapy (self-care training) CPT Code: `97535`	—	—	$38	unverified
Flu vaccine injection HCPCS Code: `G0008`	—	—	$48	—
Pneumonia vaccine injection HCPCS Code: `G0009`	—	—	$49	—
Diagnostic procedure preparation HCPCS Code: `G0279`	—	—	$35	unverified
Electrical stimulation therapy HCPCS Code: `G0283`	—	—	$14	—

Showing top 25 high-impact procedures of 129 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 65.0%

Audit a Bill or Quote at Duncan Regional Hospital, Inc (Zero PHI Required)

CMS CCN: 370023

CPT 27130

Select Procedure to Audit:

Fair BaseRate™ $13,413

Medicare Rate $13,117

Self-Pay Cash $26,233

Insurer Median $35,662

1. Amount on Your Bill or Quote ($) Pre-filled with Duncan Regional Hospital, Inc’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: $55,633 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $55,633

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (65.0% of gross = $55,633).

Step 2 · Cash vs. Insurance Arbitrage Save $59,356 Paying Cash

Self-Pay Cash Rate ($26,233) Beats Your Bill

Duncan Regional Hospital, Inc's published 45 CFR § 180 self-pay cash rate is $26,233 (vs. $35,662 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$72,176 Above Fair BaseRate

Negotiate Toward $13,413 Fair BaseRate ($13,117 Medicare)

Your bill ($85,589) is $72,176 above the denoised Fair BaseRate ($13,413) and 6.5× the $13,117 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: 731008550

Filing Period: 197611

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 (65.0% 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 Overall3/5 Stars (3/5)

Safety Composite64/100

Would Recommend64%

Rated 9 or 10 (HCAHPS)68%

Median ER Wait148 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate3.1%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionsame

C. diff Hospital-Onset Infectionsame

Source: CMS Hospital Care Compare (413 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 Value & Quality Leader Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Duncan Regional Hospital, Inc.

Price Index: 1.00× regional baseline

Quality: 56/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Humana

-56.5%

Median Household Income$60,236U.S. Census ACS

Local Uninsured Share13.4%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 72/100 · Corroborated CMS CCN 370023 EIN 731008550

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 370023) ↗ Verify IRS Form 990 (EIN 731008550) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-03-14

Validated Rate Rows1,483 (CMS v3.0.0)

File Integrity DigestVerified · CCN 370023

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