St Lukes Hospital
801 Ostrum Street, Bethlehem, PA 18015 · 117 Priced Procedures · 77% Patient Recommendation
Typical commercial prices here match the fair market benchmark (0.98×) after accounting for local nurse/doctor wages and patient complexity.
4-Star CMS clinical quality rating paired with 0.98× fair market pricing.
Aligned Regional Benchmark Peer
St Lukes Hospital prices shoppable and inpatient services (1.0× to 1.3× Medicare, divergence 1.30×) 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 2% of shoppable procedures (97/100 Cash Honesty)
- 5-Star CMS clinical rating with 77% patient recommendation (79/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (17.3% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.2× markup over Medicare rates
- Captive ER (0.9×) & laboratory (3.8×) services average 1.30× higher multiples than routine shoppable care (1.0×)
- Even at low-cost facilities (0.98× 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.
- Consolidated metro market (HHI 4,032) 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 St Lukes Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 117 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $31,506 | 1.0× |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $19,461 | 1.0× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $19,330 | 1.0× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $17,571 | 1.0× |
| Total hip replacement CPT Code: 27130 | $13,765 | 1.0× |
| Total knee replacement CPT Code: 27447 | $13,765 | 1.0× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $8,311 | 1.0× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $6,242 | 1.0× |
| Breast lump removal CPT Code: 19120 | $3,940 | 1.0× |
| Inguinal hernia repair CPT Code: 49505 | $3,667 | 1.0× |
| Bunion correction surgery CPT Code: 28296 | $3,471 | unverified |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $3,372 | 1.0× |
| Cataract surgery with lens implant CPT Code: 66984 | $2,370 | 0.9× |
| Trauma team activation HCPCS Code: G0390 | $1,382 | 1.0× |
| Colonoscopy with biopsy CPT Code: 45380 | $1,219 | 1.0× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $1,052 | unverified |
| Upper endoscopy with biopsy CPT Code: 43239 | $969 | 1.0× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $943 | 1.0× |
| Speech therapy (language evaluation) CPT Code: 92507 | $606 | 7.0× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $570 | 1.0× |
| Injection procedure for pain management HCPCS Code: G0260 | $589 | 0.7× |
| Blood transfusion CPT Code: 36430 | $452 | 0.9× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $392 | 0.8× |
| MRI, brain (no contrast) CPT Code: 70551 | $362 | 1.1× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $373 | 0.8× |
Audit a Bill or Quote at St Lukes Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $13,081
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (17.3% of gross = $13,081).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask St Lukes Hospital'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 $30,775 Fair BaseRate ($23,504 Medicare)
Your bill ($75,614) is $44,839 above the denoised Fair BaseRate ($30,775) and 3.2× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (17.3% 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.
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 (579 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 St Lukes Hospital.
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.