Roper St Francis Hospital-Berkeley Inc
100 Callen Blvd., Summerville, SC 29486 · 100 Priced Procedures · 82% Patient Recommendation
Typical commercial prices here match the fair market benchmark (1.02×) after accounting for local nurse/doctor wages and patient complexity.
4-Star CMS clinical quality rating paired with 1.02× fair market pricing.
Loss-Leader / Captive Ancillary Cross-Subsidizer
Roper St Francis Hospital-Berkeley Inc prices routine shoppable procedures near 1.1× Medicare (p50 0.95×) while skewing captive emergency, lab, and upper-quartile codes to 1.8× Medicare (p75 1.24×, +31% 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 0.92× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 0% of shoppable procedures (99/100 Cash Honesty)
- 5-Star CMS clinical rating with 82% patient recommendation (73/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (14.2% 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 1.64× higher multiples than routine shoppable care (1.1×)
- Upper-quartile procedures (Q75 1.24×) jump +31% above the median procedure ratio (Q50 0.95×)
- 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 St Francis Hospital-Berkeley Inc
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 100 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $35,748 | 1.9× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $24,126 | 1.2× |
| Total hip replacement CPT Code: 27130 | $12,337 | 0.9× |
| Total knee replacement CPT Code: 27447 | $12,125 | 0.9× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $7,145 | 0.9× |
| Inguinal hernia repair CPT Code: 49505 | $5,934 | 1.6× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $5,710 | 0.9× |
| Breast lump removal CPT Code: 19120 | $3,827 | 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× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $3,245 | 1.0× |
| 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× |
| Injection procedure for pain management HCPCS Code: G0260 | $2,410 | 2.8× |
| 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 | $1,812 | 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× |
| CT scan, chest (no contrast) CPT Code: 71250 | $1,282 | 7.7× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $1,282 | 7.6× |
Audit a Bill or Quote at Roper St Francis Hospital-Berkeley Inc (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $12,191
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (14.2% of gross = $12,191).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Roper St Francis Hospital-Berkeley Inc'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 ($85,795) is $66,708 above the denoised Fair BaseRate ($19,087) and 6.1× the $14,117 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (14.2% 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 (571 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 St Francis Hospital-Berkeley Inc.
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.