Falls Community Hospital and Clinic
322 Coleman Street, Marlin, TX 76661 · 89 Priced Procedures
Typical commercial prices here are 10% below the fair benchmark (0.90×) after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Uniform Value Leader · Low-Cost Across Departments
Falls Community Hospital and Clinic maintains low, disciplined commercial pricing across both routine shoppable procedures (1.0× Medicare, p50 0.91× Fair BaseRate) and emergency/ancillary services (1.0× Medicare, p75 0.95× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.
Where They're Good (Patient & Payer Edge)
- Elective shoppable care is priced 10% below peer Fair BaseRate (0.90×)
- Self-pay cash beats commercial insurance on 11% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (54/100 safety score) with 72% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (26.1% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (0.90× 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 0.91× Fair BaseRate (1.0× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Even at low-cost facilities (0.90× 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 6,419) 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 Falls Community Hospital and Clinic
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 89 published procedures.
Audit a Bill or Quote at Falls Community Hospital and Clinic (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $896
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (26.1% of gross = $896).
Self-Pay Cash Rate ($2,750) Beats Your Bill
Falls Community Hospital and Clinic's published 45 CFR § 180 self-pay cash rate is $2,750 (vs. $1,083 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $1,256 Fair BaseRate ($1,223 Medicare)
Your bill ($3,437) is $2,181 above the denoised Fair BaseRate ($1,256) and 2.8× the $1,223 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (26.1% 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
CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Falls Community Hospital and Clinic. Prior administrative notices do not necessarily reflect current compliance status.
- 2026-04-17·cap_corrective_action
CAP Request
Recorded - 2026-01-14·warning_notice
Warning Notice
Recorded - 2023-10-04·administrative_or_closure
Closure Notice
Recorded - 2023-07-20·cmp_monetary_penalty
CMP Notice
Recorded - 2023-04-19·cap_corrective_action
CAP Request
Recorded - 2023-01-09·warning_notice
Warning Notice
Recorded
Source: CMS Hospital Care Compare. 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 Falls Community Hospital and Clinic.
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.