How many shoppable procedure prices are published for PAM Specialty Hospital of Wilkes-Barre?

PAM Specialty Hospital of Wilkes-Barre in Wilkes-Barre, PA currently has 69 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do PAM Specialty Hospital of Wilkes-Barre's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, PAM Specialty Hospital of Wilkes-Barre's median negotiated commercial rate is 1.4× the regionally adjusted fair BaseRate benchmark.

Hospital Profile General Acute Care Hospital Updated: 2025-09-11

PAM Specialty Hospital of Wilkes-Barre

575 North River St, Wilkes-Barre, PA 18764 · 69 Priced Procedures

CMS Overall Rating No CMS Rating

Above Fair Market · Negotiate

1.43×vs. Fair Market Price

Typical commercial prices here are +43% above the fair benchmark (1.43×) even after accounting for local nurse/doctor wages and patient complexity.

62/100 · Caution

62/100Self-Pay Cash Beats Insurance 2% of the Time

File Completeness66

Price Logic96

Peer Alignment56

Clean Billing70

Real Cash Discount6

High-Markup · Check Safety

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

PAM Specialty Hospital of Wilkes-Barre prices shoppable and inpatient services (2.0× to 2.0× Medicare, divergence 1.00×) in alignment with regional hospital peers (1.43× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#113 of 134 in PA · 83rd State Percentile#2,525 of 3,385 in U.S. · 74th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.07× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 2% of shoppable procedures (25/100 Cash Honesty)
CMS clinical safety score (54/100 safety score) with 72% patient recommendation
Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.43× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
Commercial insurance median sits at 1.44× Fair BaseRate (2.0× Medicare), so insured patients should always compare the self-pay cash price before paying.
Specialty infusion drugs (J-codes) average 2.3× Medicare — verify per-unit billing on itemized statements
Unnegotiated chargemaster list prices average 16.6× Medicare (25¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

2.0× Medicare

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

Back-Door Captive & ER1.00× Divergence

2.0× Medicare

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

Quantile Tail Spread+14% Upper Tail

Q25 1.07× · Q50 1.44× · Q75 1.64×

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

2.0× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.5× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.5× MedicareFair

Back-Door Captive ER VisitsBack-Door Captive

2.9× MedicareFair

Inpatient Lab & PathologyBack-Door Captive

3.6× MedicareElevated

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

2.3× MedicareFair

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

2% Cash Edge · 25/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 54/100Elevated

Procedure Prices at PAM Specialty Hospital of Wilkes-Barre

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 69 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$39,614	$19,087	2.1×
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	—	$32,806	$30,775	1.1×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$31,802	$19,432	1.6×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$22,306	$17,936	1.2×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$8,595	$8,595	$448	19.2×
MRI, lower back (no contrast) CPT Code: `72148`	$6,557	$6,557	$338	19.4×
MRI, brain (no contrast) CPT Code: `70551`	$6,557	$6,557	$343	19.1×
MRI, knee or other leg joint CPT Code: `73721`	$6,557	$6,557	$369	17.8×
CT scan, head (with and without contrast) CPT Code: `70470`	$6,382	$6,382	$258	24.7×
CT scan, head (with contrast) CPT Code: `70460`	$5,730	$5,730	$242	23.7×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$5,563	$5,563	$303	18.4×
MRI, brain (with and without contrast) CPT Code: `70553`	$3,961	$3,961	$511	7.8×
CT scan, head (no contrast) CPT Code: `70450`	$3,708	$3,708	$160	23.2×
CT scan, pelvis CPT Code: `72192`	$3,708	$3,708	$163	22.7×
CT scan, sinuses CPT Code: `70486`	$3,708	$3,708	$166	22.3×
CT scan, chest (no contrast) CPT Code: `71250`	$3,708	$3,708	$167	22.2×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$3,708	$3,708	$168	22.1×
CT scan, neck (cervical spine) CPT Code: `72125`	$3,708	$3,708	$169	21.9×
Upper endoscopy with biopsy CPT Code: `43239`	$2,503	$2,503	$987	2.5×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,782	$1,782	$272	6.6×
Ultrasound, pelvis CPT Code: `76856`	$1,176	$1,176	$130	9.0×
Ultrasound, abdomen (complete) CPT Code: `76700`	$1,176	$1,176	$134	8.8×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,106	$1,106	$583	1.9×
Ultrasound, abdomen (limited) CPT Code: `76705`	$1,018	$1,018	$126	8.1×
Ultrasound, thyroid and neck CPT Code: `76536`	$1,007	$1,007	$132	7.6×
Blood transfusion CPT Code: `36430`	$744	$744	$498	1.5×
X-ray, shoulder CPT Code: `73030`	$593	$593	$92	6.4×
X-ray, chest (two views) CPT Code: `71046`	$572	$572	$93	6.2×
X-ray, pelvis CPT Code: `72170`	$581	$581	$110	5.3×
X-ray, hip CPT Code: `73502`	$486	$486	$93	5.2×
X-ray, neck (cervical spine) CPT Code: `72040`	$420	$420	$93	4.5×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$363	$363	$64	5.7×
X-ray, chest (single view) CPT Code: `71045`	$321	$321	$92	3.5×
X-ray, foot CPT Code: `73630`	$319	$319	$92	3.5×
X-ray, lower back CPT Code: `72110`	$271	$271	$112	2.4×
Speech therapy (language evaluation) CPT Code: `92507`	$240	$240	$86	2.8×
Physical therapy (manual therapy) CPT Code: `97140`	$135	$135	$34	4.0×
Breathing treatment (nebulizer) CPT Code: `94640`	$154	$154	$201	0.8×
Physical therapy (gait training) CPT Code: `97116`	$117	$117	$33	3.5×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$117	$117	$35	3.3×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$117	$117	$38	3.1×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$117	$117	$40	2.9×
Occupational therapy (self-care training) CPT Code: `97535`	$110	$110	$38	2.9×
Orthotic fitting and training CPT Code: `97760`	$116	$116	$51	2.3×
Drug screening test HCPCS Code: `G0480`	$835	$835	$116	7.2×
Blood test, vitamin D CPT Code: `82306`	$773	$773	$31	24.9×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$609	$609	$11	55.4×
Blood test, basic metabolic panel CPT Code: `80048`	$467	$467	$9	51.9×
Blood test, liver function panel CPT Code: `80076`	$390	$390	$9	43.3×
Culture, bacterial CPT Code: `87070`	$329	$329	$9	36.6×
Culture, blood CPT Code: `87040`	$347	$347	$11	31.5×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$244	$244	$14	17.4×
Blood test, PSA (prostate screen) CPT Code: `84153`	$264	$264	$19	13.9×
Blood test, thyroid (TSH) CPT Code: `84443`	$229	$229	$18	12.7×
Blood antibody screen CPT Code: `86850`	$231	$231	$46	5.0×
Blood test, lipase CPT Code: `83690`	$199	$199	$7	28.4×
Blood test, ferritin (iron stores) CPT Code: `82728`	$221	$221	$14	15.8×
Hepatitis C antibody test CPT Code: `86803`	$214	$214	$15	14.3×
Blood test, vitamin B12 CPT Code: `82607`	$225	$225	$16	14.1×
Blood test, hemoglobin CPT Code: `85018`	$198	$198	$3	66.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$163	$163	$6	27.2×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$135	$135	$5	27.0×
Blood test, potassium CPT Code: `84132`	$118	$118	$5	23.6×
Blood test, amylase CPT Code: `82150`	$135	$135	$7	19.3×
Blood test, magnesium CPT Code: `83735`	$135	$135	$7	19.3×
Blood test, complete blood count (CBC) CPT Code: `85025`	$141	$141	$8	17.6×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$153	$153	$10	15.3×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$108	$108	$3	36.0×
Blood test, calcium CPT Code: `82310`	$82	$82	$5	16.4×

Showing top 25 high-impact procedures of 69 total

Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at PAM Specialty Hospital of Wilkes-Barre (Zero PHI Required)

CMS CCN: 392025

CPT 871

Select Procedure to Audit:

Fair BaseRate™ $19,087

Medicare Rate $14,117

Self-Pay Cash Request Quote

Insurer Median $39,614

1. Amount on Your Bill or Quote ($) Pre-filled with PAM Specialty Hospital of Wilkes-Barre’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 274% of 2026 FPL

Above Standard 400% FPL Financial-Assistance Ceiling

At 274% FPL, you exceed the standard 400% FPL tier, though medical-hardship caps (when bills exceed 10% of annual income) may still apply.

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

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask PAM Specialty Hospital of Wilkes-Barre'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 +$75,987 Above Fair BaseRate

Negotiate Toward $19,087 Fair BaseRate ($14,117 Medicare)

Your bill ($95,074) is $75,987 above the denoised Fair BaseRate ($19,087) and 6.7× the $14,117 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) For-Profit / Non-501(c)(3)

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Public IRS & CMS ownership records classify PAM Specialty Hospital of Wilkes-Barre as a non-501(c)(3) facility. Federal 26 U.S.C. § 501(r) statutory charity-care caps apply specifically to tax-exempt nonprofit hospitals, though state hospital fair-pricing statutes and prompt-pay self-pay discounts may still apply.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

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 PAM Specialty Hospital of Wilkes-Barre.

Price Index: 2.65× regional baseline

Quality: 54/100 CMS composite

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 62/100 · Caution CMS CCN 392025

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 392025) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2025-09-11

Validated Rate Rows724 (CMS v3.0.0)

File Integrity DigestVerified · CCN 392025

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