How many shoppable procedure prices are published for Hamilton General Hospital?

Hamilton General Hospital in Hamilton, TX currently has 97 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

Hospital Profile Critical Access Hospital Government - Hospital District or Authority 25 Beds · rural Updated: 2026-02-25

Hamilton General Hospital

400 N Brown, Building 1, Hamilton, TX 76531 · 97 Priced Procedures · 83% Patient Recommendation

CMS Overall Rating No CMS Rating

Near Fair BaseRate Benchmark

1.00×vs. Fair Market Price

Typical commercial prices here match the fair market benchmark (1.00×) after accounting for local nurse/doctor wages and patient complexity.

66/100 · Caution

66/100Self-Pay Cash Beats Insurance 45% of the Time

File Completeness66

Price Logic44

Peer Alignment65

Clean Billing67

Real Cash Discount100

Regional Value Leader

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

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Hamilton General Hospital prices shoppable and inpatient services (7.8× to 9.2× Medicare, divergence 1.18×) in alignment with regional hospital peers (1.00× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

Regional Benchmark in TXU.S. National Reference Pool

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.78× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 45% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (73/100 safety score) with 83% patient recommendation
Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 2.8× markup over Medicare rates
Captive ER (4.3×) & laboratory (17.4×) services average 1.18× higher multiples than routine shoppable care (7.8×)
Upper-quartile procedures (Q75 1.28×) jump +28% above the median procedure ratio (Q50 1.00×)
Unnegotiated chargemaster list prices average 10.7× Medicare (17¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

7.8× Medicare

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

Back-Door Captive & ER1.18× Divergence

9.2× Medicare

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

Quantile Tail Spread+28% Upper Tail

Q25 0.78× · Q50 1.00× · Q75 1.28×

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

7.8× MedicareWatchout

Outpatient Surgery & ORBack-Door Captive

2.8× MedicareFair

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

10.0× MedicareWatchout

Back-Door Captive ER VisitsBack-Door Captive

4.3× MedicareElevated

Inpatient Lab & PathologyBack-Door Captive

17.4× MedicareWatchout

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

2.5× MedicareFair

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

45% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 73/100Fair

Procedure Prices at Hamilton General Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 97 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Total knee replacement CPT Code: `27447`	$18,908	$18,908	$13,523	1.4×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$5,540	$5,540	$3,372	1.6×
Bunion correction surgery CPT Code: `28296`	$5,124	$5,124	$3,446	1.5×
Breast lump removal CPT Code: `19120`	$5,141	$5,141	$3,875	1.3×
Inguinal hernia repair CPT Code: `49505`	$5,053	$5,053	$3,629	1.4×
Cataract surgery with lens implant CPT Code: `66984`	$3,931	$3,931	$2,540	1.5×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$3,915	$3,915	$6,109	0.6×
Trauma team activation HCPCS Code: `G0390`	$3,515	$3,515	$1,453	2.4×
Sleep study (overnight, in lab) CPT Code: `95810`	$2,676	$2,676	$1,021	2.6×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,641	$2,641	$511	5.2×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,428	$2,428	$448	5.4×
MRI, lower back (no contrast) CPT Code: `72148`	$1,925	$1,925	$338	5.7×
MRI, knee or other leg joint CPT Code: `73721`	$1,893	$1,893	$369	5.1×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,790	$1,790	$258	6.9×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,755	$1,755	$303	5.8×
MRI, brain (no contrast) CPT Code: `70551`	$1,706	$1,706	$343	5.0×
Upper endoscopy with biopsy CPT Code: `43239`	$1,592	$1,592	$987	1.6×
CT scan, head (with contrast) CPT Code: `70460`	$1,555	$1,555	$242	6.4×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,345	$1,345	$169	8.0×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,364	$1,364	$583	2.3×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,337	$1,337	$168	8.0×
Colonoscopy with biopsy CPT Code: `45380`	$1,326	$1,326	$1,256	1.1×
CT scan, pelvis CPT Code: `72192`	$1,252	$1,252	$163	7.7×
CT scan, chest (no contrast) CPT Code: `71250`	$1,273	$1,273	$167	7.6×
CT scan, sinuses CPT Code: `70486`	$1,211	$1,211	$166	7.3×
Colonoscopy (diagnostic) CPT Code: `45378`	$1,235	$1,235	$981	1.3×
CT scan, head (no contrast) CPT Code: `70450`	$1,198	$1,198	$160	7.5×
Blood transfusion CPT Code: `36430`	$784	$784	$498	1.6×
Ultrasound, abdomen (complete) CPT Code: `76700`	$716	$716	$134	5.3×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$695	$695	$272	2.6×
Ultrasound, pelvis CPT Code: `76856`	$560	$560	$130	4.3×
Ultrasound, thyroid and neck CPT Code: `76536`	$512	$512	$132	3.9×
Ultrasound, abdomen (limited) CPT Code: `76705`	$335	$335	$126	2.7×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$352	$352	$148	2.4×
X-ray, lower back CPT Code: `72110`	$307	$307	$112	2.7×
X-ray, chest (two views) CPT Code: `71046`	$265	$265	$93	2.8×
Screening mammogram (both breasts) CPT Code: `77067`	$284	$284	$123	2.3×
X-ray, chest (single view) CPT Code: `71045`	$247	$247	$92	2.7×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$214	$214	$64	3.3×
Speech therapy (language evaluation) CPT Code: `92507`	$200	$200	$86	2.3×
New patient office visit (30-44 min) CPT Code: `99203`	$203	$203	$110	1.8×
X-ray, pelvis CPT Code: `72170`	$191	$191	$110	1.7×
Office visit, established patient (30-39 min) CPT Code: `99214`	$202	$202	$123	1.6×
Breathing treatment (nebulizer) CPT Code: `94640`	$196	$196	$201	1.0×
X-ray, hip CPT Code: `73502`	$163	$163	$93	1.8×
X-ray, shoulder CPT Code: `73030`	$155	$155	$92	1.7×
X-ray, ankle CPT Code: `73610`	$155	$155	$93	1.7×
X-ray, foot CPT Code: `73630`	$149	$149	$92	1.6×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$122	$122	$40	3.0×
Office visit, established patient (20-29 min) CPT Code: `99213`	$137	$137	$87	1.6×
X-ray, hand CPT Code: `73130`	$146	$146	$93	1.6×
X-ray, neck (cervical spine) CPT Code: `72040`	$140	$140	$93	1.5×
Physical therapy (manual therapy) CPT Code: `97140`	$101	$101	$34	3.0×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$94	$94	$35	2.7×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$100	$100	$38	2.6×
Prosthetic fitting and training CPT Code: `97761`	$94	$94	$45	2.1×
Physical therapy (gait training) CPT Code: `97116`	$113	$113	$33	unverified
Orthotic fitting and training CPT Code: `97760`	$86	$86	$51	1.7×
Typhoid vaccine HCPCS Code: `90675`	$755	$755	$347	2.2×
Drug screening test HCPCS Code: `G0480`	$328	$328	$116	2.8×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$196	$196	$11	17.8×
Blood test, vitamin D CPT Code: `82306`	$221	$221	$31	7.1×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$199	$199	$111	1.8×
Pneumococcal vaccine HCPCS Code: `90732`	$205	$205	$140	1.5×
Blood test, basic metabolic panel CPT Code: `80048`	$166	$166	$9	unverified
Blood test, PSA (prostate screen) CPT Code: `84153`	$130	$130	$19	6.8×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$131	$131	$14	unverified
Blood test, liver function panel CPT Code: `80076`	$141	$141	$9	unverified
Blood test, amylase CPT Code: `82150`	$115	$115	$7	unverified
Blood test, vitamin B12 CPT Code: `82607`	$111	$111	$16	unverified
Blood test, ferritin (iron stores) CPT Code: `82728`	$125	$125	$14	unverified
Blood test, thyroid (TSH) CPT Code: `84443`	$144	$144	$18	unverified
Blood test, clotting time (PT/INR) CPT Code: `85610`	$159	$159	$5	unverified
Blood test, clotting time (PTT) CPT Code: `85730`	$167	$167	$6	unverified
Hepatitis C antibody test CPT Code: `86803`	$176	$176	$15	unverified
Culture, blood CPT Code: `87040`	$182	$182	$11	unverified
Blood antibody screen CPT Code: `86850`	$123	$123	$46	2.7×
Culture, bacterial CPT Code: `87070`	$144	$144	$9	unverified
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$118	$118	$20	5.9×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$95	$95	$56	1.7×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$66	$66	$39	1.7×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$89	$89	$10	unverified
Blood test, lipase CPT Code: `83690`	$110	$110	$7	unverified
Blood test, complete blood count (CBC) CPT Code: `85025`	$121	$121	$8	unverified
Blood test, magnesium CPT Code: `83735`	$91	$91	$7	unverified
Flu vaccine (high dose) HCPCS Code: `90656`	$45	$45	$25	1.8×
Occupational therapy (self-care training) CPT Code: `97535`	$65	$65	$38	1.7×
Pneumonia vaccine injection HCPCS Code: `G0009`	$64	$64	$49	1.3×
Blood test, creatinine (kidney) CPT Code: `82565`	$61	$61	$5	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	$79	$79	$86	unverified
Flu vaccine injection HCPCS Code: `G0008`	$32	$32	$48	0.7×
Blood test, calcium CPT Code: `82310`	$30	$30	$5	unverified
Blood test, glucose (blood sugar) CPT Code: `82947`	$42	$42	$4	unverified
Blood test, potassium CPT Code: `84132`	$41	$41	$5	unverified
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$53	$53	$4	unverified
Blood test, sodium CPT Code: `84295`	$24	$24	$5	unverified
Blood test, hemoglobin CPT Code: `85018`	$35	$35	$3	unverified

Showing top 25 high-impact procedures of 97 total

Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at Hamilton General Hospital (Zero PHI Required)

CMS CCN: 451392

CPT 27447

Select Procedure to Audit:

Fair BaseRate™ $13,523

Medicare Rate $13,117

Self-Pay Cash $18,908

Insurer Median $18,908

1. Amount on Your Bill or Quote ($) Pre-filled with Hamilton General 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 274% of 2026 FPL

Above Standard 400% FPL Financial-Assistance Ceiling

At 274% FPL, you exceed the standard 400% FPL tier, though medical-hardship caps (when bills exceed 10% of annual income) may still apply.

Step 2 · Cash vs. Insurance Arbitrage Save $12,606 Paying Cash

Self-Pay Cash Rate ($18,908) Beats Your Bill

Hamilton General Hospital's published 45 CFR § 180 self-pay cash rate is $18,908 (vs. $18,908 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$17,991 Above Fair BaseRate

Negotiate Toward $13,523 Fair BaseRate ($13,117 Medicare)

Your bill ($31,514) is $17,991 above the denoised Fair BaseRate ($13,523) and 2.4× the $13,117 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) For-Profit / Non-501(c)(3)

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

Public IRS & CMS ownership records classify Hamilton General Hospital as a non-501(c)(3) facility. Federal 26 U.S.C. § 501(r) statutory charity-care caps apply specifically to tax-exempt nonprofit hospitals, though state hospital fair-pricing statutes and prompt-pay self-pay discounts may still apply.

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 Composite73/100

Would Recommend83%

Rated 9 or 10 (HCAHPS)83%

Median ER Wait112 min

Left ER Before Seen0%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

C. diff Hospital-Onset Infectionsame

Source: CMS Hospital Care Compare (81 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

Higher-Quality, Above-Median Price Tier

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

Price Index: 1.19× regional baseline

Quality: 60/100 CMS composite

Median Household Income$55,339U.S. Census ACS

Local Uninsured Share14.8%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 66/100 · Caution CMS CCN 451392

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 451392) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-02-25

Validated Rate Rows178 (CMS v3.0.0)

File Integrity DigestVerified · CCN 451392

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