Lehigh Valley Hospital - Pocono
206 East Brown Street, East Stroudsburg, PA 18301 · 55 Priced Procedures · 68% Patient Recommendation
Typical commercial prices here are 3% below the fair benchmark (0.97×) after accounting for local nurse/doctor wages and patient complexity.
3-Star CMS clinical quality rating paired with 0.97× fair market pricing.
Specialty Drug & Surgical Margin Engine
Lehigh Valley Hospital - Pocono concentrates commercial margin in outpatient surgical suites (1.5× Medicare) and specialty drug infusions (5.7× Medicare) relative to routine diagnostics (1.3×). Comparing freestanding ambulatory surgery centers or specialty pharmacy options before treatment yields substantial savings.
Where They're Good (Patient & Payer Edge)
- Elective shoppable care is priced 3% below peer Fair BaseRate (0.97×)
- Self-pay cash beats commercial insurance on 0% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (62/100 safety score) with 68% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (20.4% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.5× markup over Medicare rates
- Captive ER (1.7×) & laboratory (1.6×) services average 1.25× higher multiples than routine shoppable care (1.2×)
- Specialty infusion drugs (J-codes) average 5.7× Medicare — verify per-unit billing on itemized statements
- Consolidated metro market (HHI 5,001) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
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 Lehigh Valley Hospital - Pocono
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 55 published procedures.
Audit a Bill or Quote at Lehigh Valley Hospital - Pocono (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $14,759
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (20.4% of gross = $14,759).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Lehigh Valley Hospital - Pocono'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 $19,432 Fair BaseRate ($14,044 Medicare)
Your bill ($72,346) is $52,914 above the denoised Fair BaseRate ($19,432) and 5.2× the $14,044 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Illustrative National Nonprofit Peer Median (20.4% 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)CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Lehigh Valley Hospital - Pocono. Prior administrative notices do not necessarily reflect current compliance status.
- 2025-11-03·administrative_or_closure
Closure Notice
Recorded - 2025-07-18·warning_notice
Warning Notice
Recorded
Source: CMS Hospital Care Compare (332 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 Lehigh Valley Hospital - Pocono.
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.