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Hospital Profile Acute Care Hospital Voluntary non-profit - Private 124 Beds · urban Updated: 2026-05-08

Lecom Medical Center and Behavioral Health Pav

5515 Peach Street, Erie, PA 16509 · 56 Priced Procedures · 69% Patient Recommendation

CMS Overall Rating 1 / 5 Stars
Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Above Fair Market · Negotiate
1.10×vs. Fair Market Price
Position vs. 1.00× Fair Price+10% Above Fair Price 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

Typical commercial prices here are +10% above the fair benchmark (1.10×) even after accounting for local nurse/doctor wages and patient complexity.

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).89/100 · Verified
89/100Self-Pay Cash Beats Insurance 32% of the Time
File Completeness100Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic98Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment80Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing60Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount100Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.Regional Benchmark Tier
CMS Star Rating1/5 StarsOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety Score74/100Composite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER Wait120 minMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

1-Star CMS clinical quality rating paired with 1.10× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

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

#93 of 134 in PA · 68th State Percentile#1,690 of 3,385 in U.S. · 49th National Percentile
Advantage

Where They're Good (Patient & Payer Edge)

  • Bottom-quartile procedures (Q25) price at 0.85× the peer BaseRate benchmark
  • Self-pay cash beats commercial insurance on 32% of shoppable procedures (99/100 Cash Honesty)
  • 1-Star CMS clinical rating with 69% patient recommendation (74/100 safety score)
  • IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (49.9% AGB cap)
Watchout

Where You Can Get Burned (Markup Traps)

  • Outpatient surgery & OR suites carry a 1.2× markup over Medicare rates
  • Captive ER (1.2×) & laboratory (0.9×) services average 1.10× higher multiples than routine shoppable care (1.0×)
  • Upper-quartile procedures (Q75 1.27×) jump +18% above the median procedure ratio (Q50 1.08×)
  • Consolidated metro market (HHI 4,460) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
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+18% Upper Tail
Q25 0.85× · Q50 1.08× · Q75 1.27×

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
1.1× MedicareGood
Back-Door Captive ER VisitsBack-Door Captive
1.2× MedicareGood
Inpatient Lab & PathologyBack-Door Captive
0.9× MedicareGood
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
0.5× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
32% Cash Edge · 99/100Good
CMS Clinical Safety & Star ValueIntegrity & Outcomes
1 CMS · 74/100Fair

Procedure Prices at Lecom Medical Center and Behavioral Health Pav

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 56 published procedures.

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Audit a Bill & 501(r) Cap ↓
Procedure & Billing Code This Hospital vs. Fair
Sleep study (overnight, in lab)
CPT Code: 95810
 $1,001 1.0×
Blood transfusion
CPT Code: 36430
 $547 1.1×
Psychological testing by technician
CPT Code: 96138
 $521 1.3×
Breathing treatment (nebulizer)
CPT Code: 94640
 $255 1.3×
Ultrasound, leg veins (duplex)
CPT Code: 93970
 $278 1.0×
Neurobehavioral status check
CPT Code: 96116
 $252 1.1×
Psychological testing evaluation
CPT Code: 96136
 $155 1.2×
Office visit, established patient (30-39 min)
CPT Code: 99214
 $129 1.0×
Psychotherapy session (60 minutes)
CPT Code: 90837
 $150 0.8×
Psychiatric evaluation (first visit)
CPT Code: 90791
 $150 0.8×
Office visit, established patient (20-29 min)
CPT Code: 99213
 $93 1.1×
Hospital observation (per hour)
HCPCS Code: G0378
 $85 1.0×
New patient office visit (30-44 min)
CPT Code: 99203
 $93 0.8×
Family therapy session
CPT Code: 90847
 $110 0.6×
Psychotherapy session (45 minutes)
CPT Code: 90834
 $105 0.6×
Varicella (chickenpox) vaccine
HCPCS Code: 90716
 $230 1.1×
Pneumococcal vaccine
HCPCS Code: 90732
 $175 1.3×
MMR vaccine (measles, mumps, rubella)
HCPCS Code: 90707
 $133 1.2×
Blood antibody screen
CPT Code: 86850
 $61 1.3×
Electrocardiogram (EKG, tracing only)
CPT Code: 93005
 $69 1.1×
Blood test, vitamin D
CPT Code: 82306
 $41 1.3×
Flu vaccine injection
HCPCS Code: G0008
 $58 1.2×
Pneumonia vaccine injection
HCPCS Code: G0009
 $58 1.2×
Colorectal cancer screening
HCPCS Code: G0010
 $58 1.2×
Hepatitis B vaccine
HCPCS Code: 90744
 $41 1.1×
Showing top 25 high-impact procedures of 56 total
Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 49.9%

Audit a Bill or Quote at Lecom Medical Center and Behavioral Health Pav (Zero PHI Required)

CMS CCN: 390198
CPT 95810
Fair BaseRate™ $1,021
Medicare Rate $877
Self-Pay Cash $1,469
Insurer Median $1,001
Pre-filled with Lecom Medical Center and Behavioral Health Pav’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
2026 FPL: $15,650 + $5,500 per additional person
Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $1,465 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $1,465

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (49.9% of gross = $1,465).

Step 2 · Cash vs. Insurance Arbitrage Save $1,468 Paying Cash

Self-Pay Cash Rate ($1,469) Beats Your Bill

Lecom Medical Center and Behavioral Health Pav's published 45 CFR § 180 self-pay cash rate is $1,469 (vs. $1,001 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$1,916 Above Fair BaseRate

Negotiate Toward $1,021 Fair BaseRate ($877 Medicare)

Your bill ($2,937) is $1,916 above the denoised Fair BaseRate ($1,021) and 3.3× the $877 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: 251002937
Filing Period: 195107
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 (49.9% 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 Overall1/5 Stars (1/5)
Safety Composite74/100
Would Recommend69%
Rated 9 or 10 (HCAHPS)71%
Median ER Wait120 min
Left ER Before Seen3%
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 Infectionbetter

Source: CMS Hospital Care Compare (95 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 Quality & Price Benchmark

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Lecom Medical Center and Behavioral Health Pav.

Price Index: 1.00× regional baseline
Quality: 36/100 CMS composite
Median Household Income$61,476U.S. Census ACS
Local Uninsured Share4.1%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 89/100 · Verified CMS CCN 390198 EIN 251002937

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 390198) ↗ Verify IRS Form 990 (EIN 251002937) ↗ CMS HCRIS Cost Reports ↗
Published MRF File251002937_millcreek-community-hospital_standardcharges.csv
Publication / Vintage2026-05-08 · 35.89 MB
Validated Rate Rows1,395 (CMS v3.0.0)
File Integrity Digestcb182cdbf9a6ecc9b36b…

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