Roper Hospital
316 Calhoun St, Charleston, SC 29401 · 104 Priced Procedures · 80% Patient Recommendation
Typical commercial prices here are +19% above the fair benchmark (1.19×) even after accounting for local nurse/doctor wages and patient complexity.
4-Star CMS clinical quality rating paired with 1.19× fair market pricing.
Loss-Leader / Captive Ancillary Cross-Subsidizer
Roper Hospital prices routine shoppable procedures near 1.1× Medicare (p50 0.96×) while skewing captive emergency, lab, and upper-quartile codes to 2.6× Medicare (p75 1.74×, +81% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.94× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 4% of shoppable procedures (99/100 Cash Honesty)
- 4-Star CMS clinical rating with 80% 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 (14.3% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.4× markup over Medicare rates
- Captive ER (1.6×) & laboratory (1.5×) services average 2.36× higher multiples than routine shoppable care (1.1×)
- Upper-quartile procedures (Q75 1.74×) jump +81% above the median procedure ratio (Q50 0.96×)
- Consolidated metro market (HHI 2,503) 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 Roper Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 104 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $36,505 | 1.9× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $36,250 | 1.9× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $34,691 | 1.9× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $14,343 | 1.7× |
| Total hip replacement CPT Code: 27130 | $12,603 | 0.9× |
| Total knee replacement CPT Code: 27447 | $12,603 | 0.9× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $5,834 | 1.0× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $5,070 | 1.5× |
| Breast lump removal CPT Code: 19120 | $3,714 | 1.0× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $3,658 | 3.6× |
| Inguinal hernia repair CPT Code: 49505 | $3,515 | 1.0× |
| MRI, brain (no contrast) CPT Code: 70551 | $3,288 | 9.6× |
| MRI, lower back (no contrast) CPT Code: 72148 | $3,234 | 9.6× |
| Bunion correction surgery CPT Code: 28296 | $3,259 | 0.9× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $3,186 | 10.5× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $3,186 | 7.1× |
| MRI, knee or other leg joint CPT Code: 73721 | $2,447 | 6.6× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $2,266 | 4.4× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $2,187 | 3.8× |
| CT scan, head (no contrast) CPT Code: 70450 | $1,795 | 11.2× |
| Upper endoscopy with biopsy CPT Code: 43239 | $1,820 | 1.8× |
| CT scan, head (with contrast) CPT Code: 70460 | $1,710 | 7.1× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $1,503 | 5.5× |
| CT scan, pelvis CPT Code: 72192 | $1,282 | 7.9× |
| CT scan, sinuses CPT Code: 70486 | $1,282 | 7.7× |
Audit a Bill or Quote at Roper Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $12,502
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (14.3% of gross = $12,502).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Roper 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 $19,087 Fair BaseRate ($14,117 Medicare)
Your bill ($87,612) is $68,525 above the denoised Fair BaseRate ($19,087) and 6.2× the $14,117 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (14.3% 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)CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Roper Hospital. Prior administrative notices do not necessarily reflect current compliance status.
- 2025-04-10·administrative_or_closure
Closure Notice
Recorded - 2025-02-20·cap_corrective_action
CAP Request
Recorded - 2024-11-14·warning_notice
Warning Notice
Recorded
Source: CMS Hospital Care Compare (2,501 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 Roper 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.