How many shoppable procedure prices are published for Ascension Seton Highland Lakes?

Ascension Seton Highland Lakes in Burnet, TX currently has 120 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Ascension Seton Highland Lakes's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Ascension Seton Highland Lakes's median negotiated commercial rate is 1.2× the regionally adjusted fair BaseRate benchmark.

What is Ascension Seton Highland Lakes's CMS Care Compare overall star rating?

CMS Care Compare assigns Ascension Seton Highland Lakes an overall hospital quality rating of 5 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Critical Access Hospital Voluntary non-profit - Private 25 Beds · rural Updated: 01/01/2026

Ascension Seton Highland Lakes

Highway 281 South, Burnet, TX 78611 · 120 Priced Procedures

CMS Overall Rating 5 / 5 Stars

Above Fair Market · Negotiate

1.17×vs. Fair Market Price

Typical commercial prices here are +17% above the fair benchmark (1.17×) even after accounting for local nurse/doctor wages and patient complexity.

80/100 · Corroborated

80/100Self-Pay Cash Beats Insurance 27% of the Time

File Completeness51

Price Logic95

Peer Alignment70

Clean Billing83

Real Cash Discount100

High Quality · Fair Price

5-Star CMS clinical quality rating paired with 1.17× fair market pricing.

Behavioral Pricing FingerprintUpper-Quartile Spread · +59% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Ascension Seton Highland Lakes prices routine shoppable procedures at 1.4× Medicare (median 1.00× Fair BaseRate) while upper-quartile commercial rates jump +59% to 1.59× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#144 of 307 in TX · 46th State Percentile#1,927 of 3,385 in U.S. · 56th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.82× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 27% of shoppable procedures (99/100 Cash Honesty)
5-Star CMS clinical rating with 72% patient recommendation (68/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (11.5% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.8× markup over Medicare rates
Commercial insurance median sits at 1.00× Fair BaseRate (1.4× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 1.59×) jump +59% above the median procedure ratio (Q50 1.00×)
Unnegotiated chargemaster list prices average 12.2× Medicare (14¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

1.4× Medicare

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

Back-Door Captive & ER0.93× Divergence

1.3× Medicare

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

Quantile Tail Spread+59% Upper Tail

Q25 0.82× · Q50 1.00× · Q75 1.59×

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

1.4× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.8× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.9× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.5× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

2.4× MedicareFair

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

0.7× MedicareGood

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

27% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

5 CMS · 68/100Fair

Procedure Prices at Ascension Seton Highland Lakes

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 120 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$11,474	$19,432	0.6×
Total hip replacement CPT Code: `27130`	—	$11,425	$13,413	0.9×
Total knee replacement CPT Code: `27447`	—	$11,425	$13,523	0.8×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$9,063	$8,223	1.1×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$9,063	$17,936	0.5×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$9,063	$19,087	0.5×
Trauma team activation HCPCS Code: `G0390`	$4,112	$3,030	$1,453	2.1×
C-section delivery (full package) CPT Code: `59510`	—	$2,318	$2,975	0.8×
Vaginal delivery (full package) CPT Code: `59400`	—	$2,091	$2,680	0.8×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$1,889	$6,109	0.3×
Sleep study (overnight, in lab) CPT Code: `95810`	—	$1,703	$1,021	1.7×
Inguinal hernia repair CPT Code: `49505`	—	$1,152	$3,629	0.3×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$1,088	$3,372	0.3×
Bunion correction surgery CPT Code: `28296`	—	$1,088	$3,446	0.3×
Breast lump removal CPT Code: `19120`	—	$964	$3,875	0.2×
Cataract surgery with lens implant CPT Code: `66984`	—	$850	$2,540	0.3×
Injection procedure for pain management HCPCS Code: `G0260`	$959	$600	$855	0.7×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,202	$562	$583	1.0×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$3,567	$464	$448	1.0×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,972	$464	$511	0.9×
Colonoscopy with biopsy CPT Code: `45380`	—	$429	$1,256	0.3×
Blood transfusion CPT Code: `36430`	$370	$370	$498	0.7×
Upper endoscopy with biopsy CPT Code: `43239`	—	$335	$987	0.3×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$329	$981	0.3×
Office visit, established patient (30-39 min) CPT Code: `99214`	—	$272	$123	2.2×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$529	$290	$272	1.1×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$3,097	$292	$303	1.0×
Rabies immune globulin HCPCS Code: `90375`	$1,263	$285	$322	0.9×
MRI, lower back (no contrast) CPT Code: `72148`	$918	$290	$338	0.9×
MRI, brain (no contrast) CPT Code: `70551`	$944	$294	$343	0.9×
MRI, knee or other leg joint CPT Code: `73721`	$786	$292	$369	0.8×
New patient office visit (30-44 min) CPT Code: `99203`	—	$263	$110	unverified
CT scan, head (with contrast) CPT Code: `70460`	$1,187	$225	$242	0.9×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,627	$225	$258	0.9×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$218	$187	$64	2.9×
Office visit, established patient (20-29 min) CPT Code: `99213`	—	$176	$87	2.0×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$65	$145	$40	3.6×
Speech therapy (language evaluation) CPT Code: `92507`	$167	$167	$86	1.9×
Group therapy session CPT Code: `90853`	$160	$160	$100	1.6×
X-ray, pelvis CPT Code: `72170`	$169	$137	$110	1.2×
X-ray, lower back CPT Code: `72110`	$215	$137	$112	1.2×
Ultrasound, abdomen (limited) CPT Code: `76705`	$309	$137	$126	1.1×
Ultrasound, pelvis CPT Code: `76856`	$270	$137	$130	1.1×
Ultrasound, thyroid and neck CPT Code: `76536`	$328	$137	$132	1.0×
Ultrasound, abdomen (complete) CPT Code: `76700`	$311	$137	$134	1.0×
Hepatitis B immune globulin HCPCS Code: `90371`	$132	$137	$151	0.9×
Family therapy session CPT Code: `90847`	$156	$156	$173	0.9×
Psychotherapy session (60 minutes) CPT Code: `90837`	$160	$160	$181	0.9×
Psychiatric evaluation (first visit) CPT Code: `90791`	$160	$160	$185	0.9×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$63	$128	$38	3.4×
Physical therapy (gait training) CPT Code: `97116`	$59	$110	$33	3.3×
Occupational therapy (self-care training) CPT Code: `97535`	$71	$123	$38	3.2×
Physical therapy (functional capacity test) CPT Code: `97750`	$46	$121	$38	3.2×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$50	$110	$35	3.1×
CT scan, head (no contrast) CPT Code: `70450`	$1,268	$135	$160	0.8×
Physical therapy (manual therapy) CPT Code: `97140`	$61	$101	$34	3.0×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$241	$123	$148	0.8×
CT scan, pelvis CPT Code: `72192`	$1,910	$135	$163	0.8×
CT scan, chest (no contrast) CPT Code: `71250`	$571	$137	$167	0.8×
CT scan, sinuses CPT Code: `70486`	$1,214	$135	$166	0.8×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,383	$135	$168	0.8×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,909	$135	$169	0.8×
Orthotic fitting and training CPT Code: `97760`	$86	$86	$51	1.7×
X-ray, foot CPT Code: `73630`	$159	$109	$92	1.2×
X-ray, hand CPT Code: `73130`	$198	$109	$93	1.2×
X-ray, shoulder CPT Code: `73030`	$179	$106	$92	1.2×
X-ray, neck (cervical spine) CPT Code: `72040`	$233	$106	$93	1.1×
X-ray, ankle CPT Code: `73610`	$182	$106	$93	1.1×
X-ray, chest (two views) CPT Code: `71046`	$191	$102	$93	1.1×
Screening mammogram (both breasts) CPT Code: `77067`	$145	$102	$123	0.8×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$546	$203	unverified
Typhoid vaccine HCPCS Code: `90675`	$596	$330	$347	1.0×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	—	$242	$111	2.2×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$155	$136	$56	2.4×
Pneumococcal vaccine HCPCS Code: `90732`	—	$133	$140	0.9×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	—	$95	$39	2.4×
Drug screening test HCPCS Code: `G0480`	$93	$96	$116	0.8×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$67	$25	2.7×
Flu vaccine injection HCPCS Code: `G0008`	$56	$81	$48	1.7×
Blood test, vitamin D CPT Code: `82306`	$282	$53	$31	1.7×
X-ray, hip CPT Code: `73502`	$111	$63	$93	0.7×
Psychological testing evaluation CPT Code: `96136`	—	$78	$128	0.6×
Psychological testing by technician CPT Code: `96138`	—	$78	$395	0.2×
Blood test, potassium CPT Code: `84132`	$34	$34	$5	6.8×
Electrical stimulation therapy HCPCS Code: `G0283`	$40	$49	$14	3.5×
Diagnostic procedure preparation HCPCS Code: `G0279`	$50	$56	$35	1.6×
Colorectal cancer screening HCPCS Code: `G0010`	$32	$59	$49	1.2×
Pneumonia vaccine injection HCPCS Code: `G0009`	$40	$55	$49	1.1×
Blood test, clotting time (PTT) CPT Code: `85730`	$36	$15	$6	2.5×
Culture, bacterial CPT Code: `87070`	$60	$22	$9	2.4×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$145	$14	$14	1.0×
Hepatitis B vaccine HCPCS Code: `90744`	$85	$30	$37	0.8×
Blood antibody screen CPT Code: `86850`	$99	$37	$46	0.8×
Hospital observation (per hour) HCPCS Code: `G0378`	$75	$42	$86	0.5×
X-ray, chest (single view) CPT Code: `71045`	$108	$39	$92	0.4×
Prosthetic fitting and training CPT Code: `97761`	$55	$55	$45	unverified
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$48	$9	$4	2.3×
Blood test, sodium CPT Code: `84295`	$43	$11	$5	2.2×
Blood test, magnesium CPT Code: `83735`	$134	$14	$7	2.0×
Breathing treatment (nebulizer) CPT Code: `94640`	$36	$36	$201	unverified
Blood test, hemoglobin CPT Code: `85018`	$19	$6	$3	2.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$105	$10	$5	2.0×
Blood test, lipase CPT Code: `83690`	$68	$8	$7	1.1×
Blood test, basic metabolic panel CPT Code: `80048`	$284	$9	$9	1.0×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$92	$11	$11	1.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$134	$3	$3	1.0×
Blood test, amylase CPT Code: `82150`	$193	$7	$7	1.0×
Blood test, calcium CPT Code: `82310`	$45	$5	$5	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$22	$5	$5	1.0×
Blood test, vitamin B12 CPT Code: `82607`	$48	$16	$16	1.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	$43	$14	$14	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$34	$4	$4	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$48	$10	$10	1.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$52	$19	$19	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$40	$8	$8	1.0×
Hepatitis C antibody test CPT Code: `86803`	$44	$15	$15	1.0×
Culture, blood CPT Code: `87040`	$238	$11	$11	1.0×
Blood test, thyroid (TSH) CPT Code: `84443`	$62	$17	$18	0.9×
Blood test, liver function panel CPT Code: `80076`	$196	$8	$9	0.9×
Flu vaccine (high dose) HCPCS Code: `90656`	—	$13	$25	0.5×

Showing top 25 high-impact procedures of 120 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 11.5%

Audit a Bill or Quote at Ascension Seton Highland Lakes (Zero PHI Required)

CMS CCN: 451365

CPT 470

Select Procedure to Audit:

Fair BaseRate™ $19,432

Medicare Rate $14,044

Self-Pay Cash Request Quote

Insurer Median $11,474

1. Amount on Your Bill or Quote ($) Pre-filled with Ascension Seton Highland Lakes’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 501(r) AGB Cap: $3,164 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $3,164

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (11.5% of gross = $3,164).

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

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Ascension Seton Highland Lakes'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 +$8,106 Above Fair BaseRate

Negotiate Toward $19,432 Fair BaseRate ($14,044 Medicare)

Your bill ($27,538) is $8,106 above the denoised Fair BaseRate ($19,432) and 2.0× the $14,044 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) 501(c)(3) Nonprofit Hospital

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

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (11.5% 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.

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

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall5/5 Stars (5/5)

Safety Composite68/100

Median ER Wait121 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate3.1%

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Ascension Seton Highland Lakes. Prior administrative notices do not necessarily reflect current compliance status.

2026-05-12·administrative_or_closure
Met Requirements
Recorded
2025-07-11·administrative_or_closure
Met Requirements
Recorded
2022-11-22·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Value & Quality Leader Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Ascension Seton Highland Lakes.

Price Index: 0.59× regional baseline

Quality: 80/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Aetna

+94.2%

Median Household Income$77,158U.S. Census ACS

Local Uninsured Share16.2%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 80/100 · Corroborated CMS CCN 451365

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 451365) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage01/01/2026

Validated Rate Rows6,470 (CMS v3.0.0)

File Integrity DigestVerified · CCN 451365

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