Prisma Health Oconee Memorial Hospital
298 Memorial Dr, Seneca, SC 29672 · 118 Priced Procedures · 70% 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
Prisma Health Oconee Memorial Hospital prices shoppable and inpatient services (1.1× to 1.1× Medicare, divergence 1.00×) 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 42% of shoppable procedures (99/100 Cash Honesty)
- 4-Star CMS clinical rating with 70% patient recommendation (71/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (23.2% AGB cap)
Where You Can Get Burned (Markup Traps)
- 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.
- Commercial insurance median sits at 0.99× Fair BaseRate (1.1× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Specialty infusion drugs (J-codes) average 1.4× Medicare — verify per-unit billing on itemized statements
- Consolidated metro market (HHI 10,000) 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 Prisma Health Oconee Memorial Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 118 published procedures.
Audit a Bill or Quote at Prisma Health Oconee Memorial Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $8,761
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (23.2% of gross = $8,761).
Self-Pay Cash Rate ($31,871) Beats Your Bill
Prisma Health Oconee Memorial Hospital's published 45 CFR § 180 self-pay cash rate is $31,871 (vs. $15,734 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $19,087 Fair BaseRate ($14,117 Medicare)
Your bill ($37,762) is $18,675 above the denoised Fair BaseRate ($19,087) and 2.7× the $14,117 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (23.2% 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 (865 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 Prisma Health Oconee Memorial 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.