How many shoppable procedure prices are published for Frio Regional Hospital?

Frio Regional Hospital in Pearsall, TX currently has 90 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Frio Regional Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Frio Regional Hospital's median negotiated commercial rate is 1.3× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Voluntary non-profit - Private 22 Beds · rural Updated: 2025-12-18

Frio Regional Hospital

200 S Ih 35, Pearsall, TX 78061 · 90 Priced Procedures · 64% Patient Recommendation

CMS Overall Rating No CMS Rating

Above Fair Market · Negotiate

1.33×vs. Fair Market Price

Typical commercial prices here are +33% above the fair benchmark (1.33×) even after accounting for local nurse/doctor wages and patient complexity.

86/100 · Verified

86/100Self-Pay Cash Beats Insurance 88% of the Time

File Completeness90

Price Logic82

Peer Alignment74

Clean Billing88

Real Cash Discount100

High-Markup Tier

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Frio Regional Hospital prices routine shoppable procedures near 1.3× Medicare (p50 1.17×) while skewing captive emergency, lab, and upper-quartile codes to 1.9× Medicare (p75 1.93×, +65% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#208 of 307 in TX · 67th State Percentile#2,328 of 3,385 in U.S. · 68th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.65× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 88% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (68/100 safety score) with 64% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (85.9% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.33× 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.
Captive ER (0.8×) & laboratory (0.9×) services average 1.46× higher multiples than routine shoppable care (1.3×)
Upper-quartile procedures (Q75 1.93×) jump +65% above the median procedure ratio (Q50 1.17×)
Unnegotiated chargemaster list prices average 6.9× Medicare (31¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

1.3× Medicare

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

Back-Door Captive & ER1.46× Divergence

1.9× Medicare

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

Quantile Tail Spread+65% Upper Tail

Q25 0.65× · Q50 1.17× · Q75 1.93×

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

1.3× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.8× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

0.9× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

0.8× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

0.9× MedicareGood

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

0.6× MedicareGood

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

88% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 68/100Fair

Procedure Prices at Frio Regional Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 90 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Knee arthroscopy with meniscus repair CPT Code: `29881`	$8,914	$2,861	$3,372	0.8×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$6,899	$2,225	$6,109	0.4×
Cataract surgery with lens implant CPT Code: `66984`	$6,558	$2,101	$2,540	0.8×
C-section delivery (full package) CPT Code: `59510`	$5,705	$1,828	$2,975	0.6×
Vaginal delivery (full package) CPT Code: `59400`	$5,166	$1,655	$2,680	0.6×
Upper endoscopy with biopsy CPT Code: `43239`	$3,861	$1,218	$987	1.2×
Colonoscopy with biopsy CPT Code: `45380`	$3,817	$1,209	$1,256	1.0×
Colonoscopy (diagnostic) CPT Code: `45378`	$3,596	$1,138	$981	1.2×
Breast lump removal CPT Code: `19120`	$1,129	$1,129	$3,875	0.3×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,680	$858	$448	1.9×
Trauma team activation HCPCS Code: `G0390`	$2,539	$813	$1,453	0.6×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,954	$626	$303	2.1×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,656	$531	$258	2.1×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,639	$526	$583	0.9×
CT scan, head (with contrast) CPT Code: `70460`	$1,517	$486	$242	2.0×
CT scan, head (no contrast) CPT Code: `70450`	$1,061	$340	$160	2.1×
CT scan, pelvis CPT Code: `72192`	$1,061	$340	$163	2.1×
CT scan, sinuses CPT Code: `70486`	$1,061	$340	$166	2.0×
CT scan, chest (no contrast) CPT Code: `71250`	$1,061	$340	$167	2.0×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,061	$340	$168	2.0×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,061	$340	$169	2.0×
Blood transfusion CPT Code: `36430`	$1,068	$342	$498	0.7×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$791	$254	$272	0.9×
MRI, brain (with and without contrast) CPT Code: `70553`	$770	$247	$511	0.5×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$650	$209	$148	1.4×
Screening mammogram (both breasts) CPT Code: `77067`	$538	$173	$123	1.4×
MRI, lower back (no contrast) CPT Code: `72148`	$490	$157	$338	0.5×
MRI, brain (no contrast) CPT Code: `70551`	$490	$157	$343	0.5×
MRI, knee or other leg joint CPT Code: `73721`	$490	$157	$369	0.4×
Ultrasound, abdomen (limited) CPT Code: `76705`	$408	$131	$126	1.0×
Ultrasound, pelvis CPT Code: `76856`	$399	$128	$130	1.0×
Ultrasound, abdomen (complete) CPT Code: `76700`	$408	$131	$134	1.0×
Ultrasound, thyroid and neck CPT Code: `76536`	$389	$124	$132	0.9×
Breathing treatment (nebulizer) CPT Code: `94640`	$403	$129	$201	0.6×
Prosthetic fitting and training CPT Code: `97761`	$302	$97	$45	2.2×
X-ray, lower back CPT Code: `72110`	$316	$102	$112	0.9×
Blood test, liver function panel CPT Code: `80076`	$140	$140	$9	15.6×
Blood test, basic metabolic panel CPT Code: `80048`	$91	$91	$9	10.1×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$91	$91	$11	8.3×
Drug screening test HCPCS Code: `G0480`	$240	$77	$116	0.7×
Blood test, creatinine (kidney) CPT Code: `82565`	$41	$41	$5	8.2×
Blood test, amylase CPT Code: `82150`	$49	$49	$7	7.0×
Blood test, vitamin D CPT Code: `82306`	$193	$62	$31	2.0×
Blood antibody screen CPT Code: `86850`	$246	$79	$46	1.7×
Physical therapy (manual therapy) CPT Code: `97140`	$181	$57	$34	1.7×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$189	$60	$38	1.6×
Occupational therapy (self-care training) CPT Code: `97535`	$146	$47	$38	1.2×
X-ray, hip CPT Code: `73502`	$207	$66	$93	0.7×
X-ray, chest (single view) CPT Code: `71045`	$189	$61	$92	0.7×
X-ray, shoulder CPT Code: `73030`	$189	$61	$92	0.7×
X-ray, foot CPT Code: `73630`	$189	$61	$92	0.7×
X-ray, chest (two views) CPT Code: `71046`	$189	$61	$93	0.7×
X-ray, neck (cervical spine) CPT Code: `72040`	$189	$61	$93	0.7×
X-ray, hand CPT Code: `73130`	$189	$61	$93	0.7×
X-ray, ankle CPT Code: `73610`	$189	$61	$93	0.7×
Speech therapy (language evaluation) CPT Code: `92507`	$173	$56	$86	0.7×
X-ray, pelvis CPT Code: `72170`	$189	$61	$110	0.6×
Office visit, established patient (30-39 min) CPT Code: `99214`	$193	$68	$123	0.6×
Office visit, established patient (20-29 min) CPT Code: `99213`	$130	$47	$87	0.5×
New patient office visit (30-44 min) CPT Code: `99203`	$147	$47	$110	0.4×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$26	$9	$3	3.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$31	$10	$4	2.5×
Blood test, calcium CPT Code: `82310`	$32	$11	$5	2.2×
Blood test, clotting time (PTT) CPT Code: `85730`	$39	$13	$6	2.2×
Blood test, glucose (blood sugar) CPT Code: `82947`	$27	$8	$4	2.0×
Blood test, lipase CPT Code: `83690`	$43	$14	$7	2.0×
Blood test, magnesium CPT Code: `83735`	$42	$14	$7	2.0×
Blood test, potassium CPT Code: `84132`	$30	$10	$5	2.0×
Blood test, sodium CPT Code: `84295`	$31	$10	$5	2.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$32	$10	$5	2.0×
Hepatitis C antibody test CPT Code: `86803`	$90	$29	$15	1.9×
Blood test, ferritin (iron stores) CPT Code: `82728`	$82	$27	$14	1.9×
Culture, blood CPT Code: `87040`	$63	$21	$11	1.9×
Culture, bacterial CPT Code: `87070`	$53	$17	$9	1.9×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$81	$26	$14	1.9×
Blood test, PSA (prostate screen) CPT Code: `84153`	$110	$35	$19	1.8×
Blood test, vitamin B12 CPT Code: `82607`	$91	$29	$16	1.8×
Blood test, thyroid (TSH) CPT Code: `84443`	$101	$32	$18	1.8×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$104	$34	$20	1.7×
Blood test, hemoglobin CPT Code: `85018`	$20	$6	$3	2.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$42	$14	$8	1.8×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$46	$15	$10	1.5×
Electrical stimulation therapy HCPCS Code: `G0283`	$50	$17	$14	1.2×
Pneumonia vaccine injection HCPCS Code: `G0009`	$110	$35	$49	0.7×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$85	$28	$40	0.7×
Physical therapy (gait training) CPT Code: `97116`	$67	$22	$33	0.7×
Colorectal cancer screening HCPCS Code: `G0010`	$98	$32	$49	0.7×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$67	$22	$35	0.6×
Flu vaccine injection HCPCS Code: `G0008`	$77	$24	$48	0.5×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$69	$22	$64	0.3×

Showing top 25 high-impact procedures of 90 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 85.9%

Audit a Bill or Quote at Frio Regional Hospital (Zero PHI Required)

CMS CCN: 451391

CPT 29881

Select Procedure to Audit:

Fair BaseRate™ $3,372

Medicare Rate $3,343

Self-Pay Cash $8,914

Insurer Median $2,861

1. Amount on Your Bill or Quote ($) Pre-filled with Frio Regional Hospital’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: $10,941 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $10,941

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (85.9% of gross = $10,941).

Step 2 · Cash vs. Insurance Arbitrage Save $3,820 Paying Cash

Self-Pay Cash Rate ($8,914) Beats Your Bill

Frio Regional Hospital's published 45 CFR § 180 self-pay cash rate is $8,914 (vs. $2,861 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$9,362 Above Fair BaseRate

Negotiate Toward $3,372 Fair BaseRate ($3,343 Medicare)

Your bill ($12,734) is $9,362 above the denoised Fair BaseRate ($3,372) and 3.8× the $3,343 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)

EIN: 741461220

Filing Period: 196412

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 (85.9% 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

Safety Composite68/100

Would Recommend64%

Rated 9 or 10 (HCAHPS)72%

Median ER Wait125 min

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

CMS Price Transparency Administrative Enforcement Log

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

2025-05-15·administrative_or_closure
Closure Notice
Recorded
2025-05-08·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (43 completed HCAHPS patient surveys). 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

Above-Benchmark Price Tier

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Frio Regional Hospital.

Price Index: 2.01× regional baseline

Quality: 53/100 CMS composite

Median Household Income$60,098U.S. Census ACS

Local Uninsured Share15.5%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 86/100 · Verified CMS CCN 451391 EIN 741461220

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 451391) ↗ Verify IRS Form 990 (EIN 741461220) ↗ CMS HCRIS Cost Reports ↗

Published MRF File741461220_frio-regional-hospital_standardcharges.json

Publication / Vintage2025-12-18 · 13.12 MB

Validated Rate Rows1,281 (CMS v3.0.0)

File Integrity Digest222dbb82399774bb784b…

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