Jefferson Einstein Montgomery Hospital
559 West Germantown Pike, East Norriton, PA 19403 · 94 Priced Procedures · 60% Patient Recommendation
Typical commercial prices here match the fair market benchmark (0.98×) after accounting for local nurse/doctor wages and patient complexity.
3-Star CMS clinical quality rating paired with 0.98× fair market pricing.
Aligned Regional Benchmark Peer
Jefferson Einstein Montgomery Hospital prices shoppable and inpatient services (1.1× to 1.2× Medicare, divergence 1.09×) in alignment with regional hospital peers (0.98× 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)
- Elective shoppable care is priced 2% below peer Fair BaseRate (0.98×)
- Self-pay cash beats commercial insurance on 82% of shoppable procedures (50/100 Cash Honesty)
- 4-Star CMS clinical rating with 60% patient recommendation (61/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (18.9% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.4× markup over Medicare rates
- Captive ER (1.6×) & laboratory (1.5×) services average 1.09× higher multiples than routine shoppable care (1.1×)
- Specialty infusion drugs (J-codes) average 1.3× Medicare — verify per-unit billing on itemized statements
- Unnegotiated chargemaster list prices average 3.8× Medicare (26¢ 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 Jefferson Einstein Montgomery Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 94 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $25,729 | 0.8× |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $16,872 | 0.9× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $16,755 | 0.9× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $14,133 | 0.8× |
| Total hip replacement CPT Code: 27130 | $13,376 | 1.0× |
| Total knee replacement CPT Code: 27447 | $13,376 | 1.0× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $6,902 | 0.8× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $6,123 | 1.0× |
| Breast lump removal CPT Code: 19120 | $3,981 | 1.0× |
| Inguinal hernia repair CPT Code: 49505 | $3,805 | 1.0× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $3,534 | 1.0× |
| Bunion correction surgery CPT Code: 28296 | $3,534 | 1.0× |
| Cataract surgery with lens implant CPT Code: 66984 | $2,597 | 1.0× |
| Colonoscopy with biopsy CPT Code: 45380 | $1,342 | 1.1× |
| Upper endoscopy with biopsy CPT Code: 43239 | $1,067 | 1.1× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $1,050 | 1.1× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $1,068 | 1.0× |
| Injection procedure for pain management HCPCS Code: G0260 | $960 | 1.1× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $575 | 1.0× |
| Blood transfusion CPT Code: 36430 | $459 | 0.9× |
| Psychological testing by technician CPT Code: 96138 | $415 | 1.1× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $407 | 0.9× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $407 | 0.8× |
| Rabies immune globulin HCPCS Code: 90375 | $322 | 1.0× |
| MRI, brain (no contrast) CPT Code: 70551 | $335 | 1.0× |
Audit a Bill or Quote at Jefferson Einstein Montgomery Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $11,665
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (18.9% of gross = $11,665).
Self-Pay Cash Rate ($43,183) Beats Your Bill
Jefferson Einstein Montgomery Hospital's published 45 CFR § 180 self-pay cash rate is $43,183 (vs. $25,729 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)
Your bill ($61,750) is $30,975 above the denoised Fair BaseRate ($30,775) and 2.6× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Illustrative National Nonprofit Peer Median (18.9% of gross — request this hospital's exact FAP Look-Back AGB percentage)
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. Hospital-specific AGB look-back percentages are published in each facility’s written Financial Assistance Policy (FAP). This figure reflects the national nonprofit peer median benchmark.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)Source: CMS Hospital Care Compare (667 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 Jefferson Einstein Montgomery Hospital.
Notable Payer Contract Outliers (SVD Matrix Anomalies)
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.