How many shoppable procedure prices are published for Clarion Hospital?

Clarion Hospital in Clarion, PA currently has 136 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Clarion Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Clarion Hospital's median negotiated commercial rate is 1.0× the regionally adjusted fair BaseRate benchmark.

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

CMS Care Compare assigns Clarion Hospital an overall hospital quality rating of 2 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 59 Beds · rural Updated: 1/1/2026

Clarion Hospital

One Hospital Drive, Clarion, PA 16214 · 136 Priced Procedures · 64% Patient Recommendation

CMS Overall Rating 2 / 5 Stars

Near Fair BaseRate Benchmark

0.96×vs. Fair Market Price

Typical commercial prices here are 4% below the fair benchmark (0.96×) after accounting for local nurse/doctor wages and patient complexity.

84/100 · Corroborated

84/100Self-Pay Cash Beats Insurance 25% of the Time

File Completeness61

Price Logic96

Peer Alignment76

Clean Billing89

Real Cash Discount100

Regional Value Leader

4-Star CMS clinical quality rating paired with 0.96× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Clarion Hospital prices shoppable and inpatient services (1.0× to 1.1× Medicare, divergence 1.10×) in alignment with regional hospital peers (0.96× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#56 of 134 in PA · 41st State Percentile#1,064 of 3,385 in U.S. · 31st National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 4% below peer Fair BaseRate (0.96×)
Self-pay cash beats commercial insurance on 25% of shoppable procedures (99/100 Cash Honesty)
2-Star CMS clinical rating with 64% patient recommendation (71/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (34.8% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.2× markup over Medicare rates
Captive ER (1.4×) & laboratory (1.5×) services average 1.10× higher multiples than routine shoppable care (1.0×)
Specialty infusion drugs (J-codes) average 1.3× Medicare — verify per-unit billing on itemized statements
Unnegotiated chargemaster list prices average 5.8× Medicare (21¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

1.0× Medicare

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

Back-Door Captive & ER1.10× Divergence

1.1× Medicare

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

Quantile Tail Spread+7% Upper Tail

Q25 0.83× · Q50 0.96× · Q75 1.03×

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

1.0× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.2× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

0.9× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.4× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.5× MedicareGood

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

1.3× MedicareGood

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

25% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

2 CMS · 71/100Fair

Procedure Prices at Clarion Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 136 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`	—	$13,121	$13,413	1.0×
Total knee replacement CPT Code: `27447`	—	$13,121	$13,523	1.0×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$6,351	$17,936	0.4×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$5,950	$6,109	1.0×
Breast lump removal CPT Code: `19120`	—	$3,831	$3,875	1.0×
C-section delivery (full package) CPT Code: `59510`	—	$3,741	$2,975	1.3×
Inguinal hernia repair CPT Code: `49505`	—	$3,531	$3,629	1.0×
Bunion correction surgery CPT Code: `28296`	—	$3,309	$3,446	1.0×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$3,246	$3,372	1.0×
Vaginal delivery (full package) CPT Code: `59400`	—	$2,497	$2,680	0.9×
Cataract surgery with lens implant CPT Code: `66984`	—	$2,326	$2,540	0.9×
Trauma team activation HCPCS Code: `G0390`	—	$1,362	$1,453	0.9×
Colonoscopy with biopsy CPT Code: `45380`	—	$1,197	$1,256	1.0×
Residential mental health treatment HCPCS Code: `H2036`	—	$1,084	$406	unverified
Sleep study (overnight, in lab) CPT Code: `95810`	$1,266	$1,018	$1,021	1.0×
Upper endoscopy with biopsy CPT Code: `43239`	—	$952	$987	1.0×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$925	$981	0.9×
Injection procedure for pain management HCPCS Code: `G0260`	$879	$713	$855	0.8×
Behavioral health residential care HCPCS Code: `H0011`	—	$683	$364	unverified
Echocardiogram (heart ultrasound) CPT Code: `93306`	$647	$559	$583	1.0×
Blood transfusion CPT Code: `36430`	$676	$433	$498	0.9×
Psychological testing by technician CPT Code: `96138`	—	$407	$395	1.0×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,283	$364	$448	0.8×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,680	$373	$511	0.7×
Behavioral health counseling (per session) HCPCS Code: `H0008`	—	$299	$257	1.2×
Behavioral health day treatment HCPCS Code: `H0010`	—	$323	$343	0.9×
Rabies immune globulin HCPCS Code: `90375`	$3,319	$297	$322	0.9×
Neurobehavioral status check CPT Code: `96116`	—	$318	$231	unverified
Ultrasound, leg veins (duplex) CPT Code: `93970`	$478	$246	$272	0.9×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$606	$246	$303	0.8×
MRI, lower back (no contrast) CPT Code: `72148`	$1,232	$256	$338	0.8×
MRI, brain (no contrast) CPT Code: `70551`	$1,120	$257	$343	0.7×
MRI, knee or other leg joint CPT Code: `73721`	$1,408	$256	$369	0.7×
Residential substance abuse treatment HCPCS Code: `H2035`	—	$160	$88	1.8×
Psychotherapy session (45 minutes) CPT Code: `90834`	—	$165	$166	1.0×
Family therapy session CPT Code: `90847`	—	$165	$173	1.0×
CT scan, head (with contrast) CPT Code: `70460`	$440	$182	$242	0.8×
CT scan, head (with and without contrast) CPT Code: `70470`	$840	$183	$258	0.7×
New patient office visit (30-44 min) CPT Code: `99203`	$148	$136	$110	1.2×
Behavioral health day program HCPCS Code: `H2012`	—	$105	$100	1.1×
Psychological testing evaluation CPT Code: `96136`	—	$130	$128	1.0×
Hepatitis B immune globulin HCPCS Code: `90371`	$345	$144	$151	1.0×
Psychotherapy session (60 minutes) CPT Code: `90837`	—	$165	$181	0.9×
Psychiatric evaluation (first visit) CPT Code: `90791`	—	$165	$185	0.9×
Review of medical records for care CPT Code: `90889`	—	$178	$114	unverified
X-ray, shoulder CPT Code: `73030`	$398	$90	$92	1.0×
X-ray, hip CPT Code: `73502`	$109	$90	$93	1.0×
X-ray, lower back CPT Code: `72110`	$167	$108	$112	1.0×
Group therapy session CPT Code: `90853`	—	$95	$100	0.9×
Care planning with family CPT Code: `90887`	—	$100	$107	0.9×
Ultrasound, abdomen (limited) CPT Code: `76705`	$460	$108	$126	0.9×
Ultrasound, pelvis CPT Code: `76856`	$225	$108	$130	0.8×
Ultrasound, thyroid and neck CPT Code: `76536`	$157	$108	$132	0.8×
Ultrasound, abdomen (complete) CPT Code: `76700`	$572	$109	$134	0.8×
Office visit, established patient (30-39 min) CPT Code: `99214`	$142	$98	$123	0.8×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$291	$111	$148	0.8×
Screening mammogram (both breasts) CPT Code: `77067`	$239	$91	$123	0.7×
CT scan, head (no contrast) CPT Code: `70450`	$290	$113	$160	0.7×
CT scan, pelvis CPT Code: `72192`	$406	$113	$163	0.7×
CT scan, sinuses CPT Code: `70486`	$320	$113	$166	0.7×
CT scan, chest (no contrast) CPT Code: `71250`	$364	$113	$167	0.7×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$526	$113	$168	0.7×
CT scan, neck (cervical spine) CPT Code: `72125`	$305	$113	$169	0.7×
Breathing treatment (nebulizer) CPT Code: `94640`	$91	$91	$201	0.5×
X-ray, chest (single view) CPT Code: `71045`	$115	$90	$92	unverified
X-ray, chest (two views) CPT Code: `71046`	$154	$90	$93	unverified
X-ray, neck (cervical spine) CPT Code: `72040`	$112	$89	$93	unverified
X-ray, pelvis CPT Code: `72170`	$134	$106	$110	unverified
X-ray, hand CPT Code: `73130`	$109	$90	$93	unverified
X-ray, ankle CPT Code: `73610`	$274	$90	$93	unverified
X-ray, foot CPT Code: `73630`	$303	$90	$92	unverified
Typhoid vaccine HCPCS Code: `90675`	$711	$333	$347	1.0×
Drug screening test HCPCS Code: `G0480`	$158	$122	$116	1.1×
Speech therapy (language evaluation) CPT Code: `92507`	$114	$77	$86	0.9×
Pneumococcal vaccine HCPCS Code: `90732`	$166	$92	$140	0.7×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$115	$59	$64	0.9×
Extended office visit (prolonged) HCPCS Code: `G2212`	—	$79	$33	unverified
Behavioral health outpatient services HCPCS Code: `H2015`	—	$27	$16	1.7×
Behavioral health living support HCPCS Code: `H2019`	—	$41	$34	1.2×
Blood test, calcium CPT Code: `82310`	$29	$6	$5	1.2×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$45	$12	$11	1.1×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$94	$29	$27	1.1×
Flu vaccine injection HCPCS Code: `G0008`	$63	$47	$48	1.0×
Pneumonia vaccine injection HCPCS Code: `G0009`	$63	$47	$49	1.0×
Colorectal cancer screening HCPCS Code: `G0010`	$63	$47	$49	1.0×
Orthotic fitting and training CPT Code: `97760`	$64	$47	$51	0.9×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$63	$15	$14	1.1×
Blood test, vitamin D CPT Code: `82306`	$99	$33	$31	1.1×
Blood test, creatinine (kidney) CPT Code: `82565`	$28	$6	$5	1.2×
Blood test, ferritin (iron stores) CPT Code: `82728`	$35	$15	$14	1.1×
Blood test, PSA (prostate screen) CPT Code: `84153`	$97	$20	$19	1.1×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$64	$21	$20	1.1×
Prosthetic fitting and training CPT Code: `97761`	—	$41	$45	0.9×
Office visit, established patient (20-29 min) CPT Code: `99213`	$113	$65	$87	0.7×
Mental health services (assessment) HCPCS Code: `H0031`	—	$61	$140	0.4×
Behavioral health counseling (group) HCPCS Code: `H0009`	—	$69	$269	0.3×
Blood test, basic metabolic panel CPT Code: `80048`	$52	$9	$9	1.0×
Blood test, liver function panel CPT Code: `80076`	$34	$9	$9	1.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$18	$3	$3	1.0×
Blood test, amylase CPT Code: `82150`	$36	$7	$7	1.0×
Blood test, vitamin B12 CPT Code: `82607`	$38	$16	$16	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$18	$4	$4	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$38	$10	$10	1.0×
Blood test, lipase CPT Code: `83690`	$38	$7	$7	1.0×
Blood test, magnesium CPT Code: `83735`	$27	$7	$7	1.0×
Blood test, potassium CPT Code: `84132`	$26	$5	$5	1.0×
Blood test, sodium CPT Code: `84295`	$20	$5	$5	1.0×
Blood test, thyroid (TSH) CPT Code: `84443`	$65	$18	$18	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$16	$4	$4	1.0×
Blood test, hemoglobin CPT Code: `85018`	$15	$3	$3	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$27	$8	$8	1.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$22	$5	$5	1.0×
Electrical stimulation therapy HCPCS Code: `G0283`	$33	$13	$14	0.9×
Physical therapy (functional capacity test) CPT Code: `97750`	$48	$34	$38	0.9×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$81	$35	$40	0.9×
Behavioral health assessment HCPCS Code: `H0001`	—	$60	$157	0.4×
Physical therapy (gait training) CPT Code: `97116`	$81	$30	$33	0.9×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$86	$33	$38	0.9×
Occupational therapy (self-care training) CPT Code: `97535`	$80	$33	$38	0.9×
Blood antibody screen CPT Code: `86850`	$69	$54	$46	unverified
Blood test, clotting time (PTT) CPT Code: `85730`	$27	$7	$6	1.2×
Hepatitis C antibody test CPT Code: `86803`	$62	$16	$15	1.1×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$87	$30	$35	0.9×
Physical therapy (manual therapy) CPT Code: `97140`	$78	$28	$34	0.8×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	—	$38	$56	0.7×
Culture, blood CPT Code: `87040`	$48	$11	$11	1.0×
Culture, bacterial CPT Code: `87070`	$48	$9	$9	1.0×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$23	$25	0.9×
Speech therapy (group session) CPT Code: `92508`	—	$24	$27	0.9×
Hepatitis B vaccine HCPCS Code: `90744`	$35	$29	$37	0.8×
Flu vaccine (high dose) HCPCS Code: `90656`	$37	$13	$25	0.5×
Diagnostic procedure preparation HCPCS Code: `G0279`	—	$16	$35	0.5×
Mental health services (therapy) HCPCS Code: `H0032`	—	$29	$65	0.4×
Hospital observation (per hour) HCPCS Code: `G0378`	$36	$36	$86	unverified
Community mental health services HCPCS Code: `H0038`	—	$6	$16	0.4×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$670	$13	$39	0.3×

Showing top 25 high-impact procedures of 136 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 34.8%

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

CMS CCN: 390093

CPT 27130

Select Procedure to Audit:

Fair BaseRate™ $13,413

Medicare Rate $13,117

Self-Pay Cash Request Quote

Insurer Median $13,121

1. Amount on Your Bill or Quote ($) Pre-filled with Clarion 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: $10,949 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $10,949

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (34.8% of gross = $10,949).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Clarion Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$18,077 Above Fair BaseRate

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

Your bill ($31,490) is $18,077 above the denoised Fair BaseRate ($13,413) and 2.4× 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: 251010039

Filing Period: 198701

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 (34.8% 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 Composite71/100

Would Recommend64%

Rated 9 or 10 (HCAHPS)70%

Median ER Wait158 min

Left ER Before Seen1%

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 Clarion Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2025-05-09·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare (260 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

Higher-Quality, Above-Median Price Tier

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

Price Index: 1.10× regional baseline

Quality: 67/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

American Health Plan

+74.3%

Devoted Health

+85.5%

Median Household Income$60,668U.S. Census ACS

Local Uninsured Share6.3%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 84/100 · Corroborated CMS CCN 390093 EIN 251010039

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 390093) ↗ Verify IRS Form 990 (EIN 251010039) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage1/1/2026

Validated Rate Rows5,568 (CMS v3.0.0)

File Integrity DigestVerified · CCN 390093

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