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Hospital Profile Critical Access Hospital Government - Hospital District or Authority 25 Beds · rural Updated: 4/1/2026

Lavaca Medical Center

1400 North Texana Street, Hallettsville, TX 77964 · 58 Priced Procedures · 88% Patient Recommendation

CMS Overall Rating 4 / 5 Stars
Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Above Fair Market · Negotiate
1.33×vs. Fair Market Price
Position vs. 1.00× Fair Price+33% Above Fair Price 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

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

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).66/100 · Caution
66/100Self-Pay Cash Beats Insurance 0% of the Time
File Completeness66Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic95Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment77Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing63Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount14Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.Regional Value Leader
CMS Star Rating4/5 StarsOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety Score74/100Composite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER Wait121 minMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

4-Star CMS clinical quality rating paired with 1.33× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Lavaca Medical Center prices shoppable and inpatient services (1.3× to 1.4× Medicare, divergence 1.08×) in alignment with regional hospital peers (1.33× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#207 of 307 in TX · 67th State Percentile#2,327 of 3,385 in U.S. · 68th National Percentile
Advantage

Where They're Good (Patient & Payer Edge)

  • Bottom-quartile procedures (Q25) price at 1.25× the peer BaseRate benchmark
  • Self-pay cash beats commercial insurance on 0% of shoppable procedures (25/100 Cash Honesty)
  • 4-Star CMS clinical rating with 88% patient recommendation (74/100 safety score)
  • 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 1.6× markup over Medicare rates
  • Captive ER (0.9×) & laboratory (1.0×) services average 1.08× higher multiples than routine shoppable care (1.3×)
  • Specialty infusion drugs (J-codes) average 1.1× Medicare — verify per-unit billing on itemized statements
  • Unnegotiated chargemaster list prices average 2.8× Medicare (36¢ 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 & ER1.08× Divergence
1.4× Medicare

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

Quantile Tail Spread+4% Upper Tail
Q25 1.25× · Q50 1.33× · Q75 1.38×

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
1.6× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
1.1× MedicareGood
Back-Door Captive ER VisitsBack-Door Captive
0.9× MedicareGood
Inpatient Lab & PathologyBack-Door Captive
1.0× MedicareGood
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
1.1× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
0% Cash Edge · 25/100Watchout
CMS Clinical Safety & Star ValueIntegrity & Outcomes
4 CMS · 74/100Fair

Procedure Prices at Lavaca Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 58 published procedures.

Sort:
Audit a Bill & 501(r) Cap ↓
Procedure & Billing Code This Hospital vs. Fair
Bunion correction surgery
CPT Code: 28296
 $2,839 0.8×
Gallbladder removal (laparoscopic)
CPT Code: 47562
 $2,408 0.4×
Trauma team activation
HCPCS Code: G0390
 $2,300 1.6×
Colonoscopy (diagnostic)
CPT Code: 45378
 $1,592 1.6×
Upper endoscopy with biopsy
CPT Code: 43239
 $1,592 1.6×
Colonoscopy with biopsy
CPT Code: 45380
 $1,592 1.3×
Diagnostic mammogram (both breasts)
CPT Code: 77066
 $152 1.0×
Speech therapy (language evaluation)
CPT Code: 92507
 $111 1.3×
Screening mammogram (both breasts)
CPT Code: 77067
 $120 1.0×
Typhoid vaccine
HCPCS Code: 90675
 $993 2.9×
Pneumococcal vaccine
HCPCS Code: 90732
 $254 1.8×
Flu vaccine (high dose)
HCPCS Code: 90656
 $104 4.2×
Tdap vaccine (tetanus, diphtheria, pertussis)
HCPCS Code: 90715
 $129 2.3×
Orthotic fitting and training
CPT Code: 97760
 $67 1.3×
Occupational therapy (therapeutic activities)
CPT Code: 97530
 $51 1.3×
Blood test, cholesterol (lipid panel)
CPT Code: 80061
 $24 1.7×
Physical therapy (gait training)
CPT Code: 97116
 $42 1.3×
Physical therapy (neuromuscular re-education)
CPT Code: 97112
 $48 1.3×
Blood test, ferritin (iron stores)
CPT Code: 82728
 $19 1.4×
Blood test, vitamin D
CPT Code: 82306
 $42 1.4×
Prosthetic fitting and training
CPT Code: 97761
 $59 1.3×
Physical therapy (functional capacity test)
CPT Code: 97750
 $49 1.3×
Occupational therapy (self-care training)
CPT Code: 97535
 $47 1.2×
Physical therapy (manual therapy)
CPT Code: 97140
 $41 1.2×
Physical therapy (therapeutic exercise)
CPT Code: 97110
 $42 1.2×
Showing top 25 high-impact procedures of 58 total
Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at Lavaca Medical Center (Zero PHI Required)

CMS CCN: 451376
CPT 28296
Fair BaseRate™ $3,446
Medicare Rate $3,343
Self-Pay Cash Request Quote
Insurer Median $2,839
Pre-filled with Lavaca Medical Center’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
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 Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Lavaca Medical Center'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 +$3,368 Above Fair BaseRate

Negotiate Toward $3,446 Fair BaseRate ($3,343 Medicare)

Your bill ($6,814) is $3,368 above the denoised Fair BaseRate ($3,446) and 2.0× 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) For-Profit / Non-501(c)(3)

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

Public IRS & CMS ownership records classify Lavaca Medical Center 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

CMS Overall4/5 Stars (4/5)
Safety Composite74/100
Would Recommend88%
Rated 9 or 10 (HCAHPS)90%
Median ER Wait121 min
Left ER Before Seen0%
30-Day Mortality vs U.S.same
Unplanned Readmissionsame

Source: CMS Hospital Care Compare (27 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

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

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Lavaca Medical Center.

Price Index: 0.50× regional baseline
Quality: 74/100 CMS composite
Median Household Income$61,768U.S. Census ACS
Local Uninsured Share11.1%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 451376

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 451376) ↗ CMS HCRIS Cost Reports ↗
Published MRF FileCMS_45_CFR_180_FILING.json
Publication / Vintage4/1/2026
Validated Rate Rows82 (CMS v3.0.0)
File Integrity DigestVerified · CCN 451376

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