How many shoppable procedure prices are published for Otto Kaiser Memorial Hospital?

Otto Kaiser Memorial Hospital in Kenedy, TX currently has 98 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Otto Kaiser Memorial Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Otto Kaiser Memorial Hospital's median negotiated commercial rate is 1.0× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Government - Hospital District or Authority 25 Beds · rural Updated: 2026-06-09

Otto Kaiser Memorial Hospital

3349 S Highway 181, Kenedy, TX 78119 · 98 Priced Procedures

CMS Overall Rating No CMS Rating

Near Fair BaseRate Benchmark

0.97×vs. Fair Market Price

Typical commercial prices here are 3% below the fair benchmark (0.97×) after accounting for local nurse/doctor wages and patient complexity.

57/100 · Caution

57/100Self-Pay Cash Beats Insurance 24% of the Time

File Completeness61

Price Logic68

Peer Alignment56

Clean Billing82

Real Cash Discount10

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

Otto Kaiser Memorial Hospital prices shoppable and inpatient services (1.3× to 1.0× Medicare, divergence 0.77×) in alignment with regional hospital peers (0.97× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#61 of 307 in TX · 19th State Percentile#1,137 of 3,385 in U.S. · 33rd National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 3% below peer Fair BaseRate (0.97×)
Self-pay cash beats commercial insurance on 24% of shoppable procedures (25/100 Cash Honesty)
CMS clinical safety score (54/100 safety score) with 72% 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)

Even at low-cost facilities (0.97× 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 0.89× Fair BaseRate (1.3× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 1.17×) jump +31% above the median procedure ratio (Q50 0.89×)
Unnegotiated chargemaster list prices average 7.1× Medicare (28¢ 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 & ER0.77× Divergence

1.0× Medicare

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

Quantile Tail Spread+31% Upper Tail

Q25 0.80× · Q50 0.89× · Q75 1.17×

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

0.5× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.5× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.9× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

2.2× MedicareFair

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

0.5× MedicareGood

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

24% Cash Edge · 25/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 54/100Elevated

Procedure Prices at Otto Kaiser Memorial Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 98 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Gallbladder removal (laparoscopic) CPT Code: `47562`	$13,466	$12,119	$6,109	unverified
Bunion correction surgery CPT Code: `28296`	$5,304	$5,304	$3,446	1.5×
Cataract surgery with lens implant CPT Code: `66984`	$4,769	$4,292	$2,540	unverified
Breast lump removal CPT Code: `19120`	$3,410	$3,154	$3,875	0.8×
Colonoscopy with biopsy CPT Code: `45380`	$2,400	$2,309	$1,256	unverified
Inguinal hernia repair CPT Code: `49505`	$2,156	$2,048	$3,629	0.6×
Colonoscopy (diagnostic) CPT Code: `45378`	$2,075	$1,919	$981	unverified
Upper endoscopy with biopsy CPT Code: `43239`	$2,010	$1,571	$987	1.6×
Blood transfusion CPT Code: `36430`	$1,523	$1,523	$498	3.1×
Hospital observation (per hour) HCPCS Code: `G0378`	$481	$481	$86	5.6×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$3,805	$462	$448	1.0×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,373	$462	$511	0.9×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$412	$412	$583	0.7×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$383	$383	$272	1.4×
Office visit, established patient (30-39 min) CPT Code: `99214`	$323	$323	$123	2.6×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$3,600	$294	$303	1.0×
MRI, lower back (no contrast) CPT Code: `72148`	$2,093	$294	$338	0.9×
MRI, brain (no contrast) CPT Code: `70551`	$2,594	$294	$343	0.9×
MRI, knee or other leg joint CPT Code: `73721`	$1,739	$294	$369	0.8×
Office visit, established patient (20-29 min) CPT Code: `99213`	$242	$242	$87	2.8×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$257	$257	$148	1.7×
CT scan, head (with contrast) CPT Code: `70460`	$1,851	$221	$242	0.9×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,947	$221	$258	0.9×
Physical therapy (gait training) CPT Code: `97116`	$172	$172	$33	5.2×
Occupational therapy (self-care training) CPT Code: `97535`	$168	$168	$38	4.4×
Speech therapy (group session) CPT Code: `92508`	$129	$129	$27	4.8×
Physical therapy (functional capacity test) CPT Code: `97750`	$147	$147	$38	3.9×
New patient office visit (30-44 min) CPT Code: `99203`	$154	$154	$110	1.4×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$114	$114	$38	3.0×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$108	$108	$40	2.7×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$119	$119	$64	1.9×
X-ray, pelvis CPT Code: `72170`	$369	$132	$110	1.2×
Ultrasound, pelvis CPT Code: `76856`	$599	$137	$130	1.1×
X-ray, chest (single view) CPT Code: `71045`	$183	$109	$92	1.2×
X-ray, shoulder CPT Code: `73030`	$182	$109	$92	1.2×
X-ray, foot CPT Code: `73630`	$222	$109	$92	1.2×
X-ray, lower back CPT Code: `72110`	$200	$132	$112	1.2×
X-ray, chest (two views) CPT Code: `71046`	$211	$109	$93	1.2×
X-ray, neck (cervical spine) CPT Code: `72040`	$231	$109	$93	1.2×
X-ray, hand CPT Code: `73130`	$213	$109	$93	1.2×
X-ray, hip CPT Code: `73502`	$221	$109	$93	1.2×
X-ray, ankle CPT Code: `73610`	$198	$109	$93	1.2×
Ultrasound, abdomen (limited) CPT Code: `76705`	$380	$132	$126	1.0×
Ultrasound, thyroid and neck CPT Code: `76536`	$290	$132	$132	1.0×
Ultrasound, abdomen (complete) CPT Code: `76700`	$433	$132	$134	1.0×
CT scan, head (no contrast) CPT Code: `70450`	$365	$132	$160	0.8×
CT scan, pelvis CPT Code: `72192`	$2,343	$132	$163	0.8×
CT scan, sinuses CPT Code: `70486`	$1,863	$132	$166	0.8×
CT scan, chest (no contrast) CPT Code: `71250`	$1,797	$132	$167	0.8×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,900	$132	$168	0.8×
CT scan, neck (cervical spine) CPT Code: `72125`	$3,343	$132	$169	0.8×
Screening mammogram (both breasts) CPT Code: `77067`	$98	$98	$123	0.8×
Breathing treatment (nebulizer) CPT Code: `94640`	$110	$110	$201	0.5×
Typhoid vaccine HCPCS Code: `90675`	$428	$428	$347	1.2×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$202	$202	$20	unverified
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$149	$149	$14	10.6×
Blood test, vitamin D CPT Code: `82306`	$156	$156	$31	5.0×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$155	$155	$203	0.8×
Drug screening test HCPCS Code: `G0480`	$143	$129	$116	1.1×
Pneumococcal vaccine HCPCS Code: `90732`	$123	$123	$140	0.9×
Blood test, lipase CPT Code: `83690`	$78	$78	$7	11.1×
Electrical stimulation therapy HCPCS Code: `G0283`	$75	$75	$14	5.4×
Hepatitis B vaccine HCPCS Code: `90744`	$83	$83	$37	2.2×
Blood test, amylase CPT Code: `82150`	$45	$45	$7	6.4×
Physical therapy (manual therapy) CPT Code: `97140`	$69	$69	$34	2.0×
Blood antibody screen CPT Code: `86850`	$75	$75	$46	1.6×
Blood test, clotting time (PTT) CPT Code: `85730`	$38	$38	$6	6.3×
Blood test, PSA (prostate screen) CPT Code: `84153`	$56	$56	$19	2.9×
Hepatitis C antibody test CPT Code: `86803`	$44	$44	$15	2.9×
Prosthetic fitting and training CPT Code: `97761`	$64	$64	$45	1.4×
Blood test, complete blood count (CBC) CPT Code: `85025`	$100	$18	$8	2.3×
Blood test, thyroid (TSH) CPT Code: `84443`	$127	$37	$18	2.1×
Pneumonia vaccine injection HCPCS Code: `G0009`	$61	$61	$49	1.2×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$43	$43	$35	1.2×
Orthotic fitting and training CPT Code: `97760`	$62	$62	$51	1.2×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$56	$56	$56	1.0×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$45	$45	$111	0.4×
Blood test, ferritin (iron stores) CPT Code: `82728`	$99	$14	$14	1.0×
Flu vaccine injection HCPCS Code: `G0008`	$36	$36	$48	0.8×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$208	$3	$3	1.0×
Blood test, magnesium CPT Code: `83735`	$55	$6	$7	0.9×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$277	$9	$11	0.8×
Culture, blood CPT Code: `87040`	$175	$9	$11	0.8×
Blood test, vitamin B12 CPT Code: `82607`	$182	$13	$16	0.8×
Blood test, calcium CPT Code: `82310`	$56	$4	$5	0.8×
Blood test, creatinine (kidney) CPT Code: `82565`	$67	$4	$5	0.8×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$159	$8	$10	0.8×
Blood test, potassium CPT Code: `84132`	$56	$4	$5	0.8×
Blood test, sodium CPT Code: `84295`	$56	$4	$5	0.8×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$61	$4	$5	0.8×
Blood test, basic metabolic panel CPT Code: `80048`	$190	$7	$9	0.8×
Blood test, liver function panel CPT Code: `80076`	$208	$7	$9	0.8×
Culture, bacterial CPT Code: `87070`	$113	$7	$9	0.8×
Blood test, glucose (blood sugar) CPT Code: `82947`	$32	$3	$4	0.8×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$69	$3	$4	0.8×
Blood test, hemoglobin CPT Code: `85018`	$29	$2	$3	0.7×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$19	$19	$39	0.5×
Sleep study (overnight, in lab) CPT Code: `95810`	$21	$21	$1,021	0.0×

Showing top 25 high-impact procedures of 98 total

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

Audit a Bill or Quote at Otto Kaiser Memorial Hospital (Zero PHI Required)

CMS CCN: 451364

CPT 47562

Select Procedure to Audit:

Fair BaseRate™ $6,109

Medicare Rate $6,176

Self-Pay Cash $13,466

Insurer Median $12,119

1. Amount on Your Bill or Quote ($) Pre-filled with Otto Kaiser Memorial 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 Published Cash: $13,466

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Otto Kaiser Memorial Hospital's published 45 CFR § 180 self-pay cash rate is $13,466 (vs. $12,119 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$7,357 Above Fair BaseRate

Negotiate Toward $6,109 Fair BaseRate ($6,176 Medicare)

Your bill ($13,466) is $7,357 above the denoised Fair BaseRate ($6,109) and 2.2× the $6,176 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 Otto Kaiser Memorial 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

CMS Price Transparency Administrative Enforcement Log

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

2025-01-17·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

Higher-Quality, Above-Median Price Tier

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Otto Kaiser Memorial Hospital.

Price Index: 1.31× regional baseline

Quality: 54/100 CMS composite

Median Household Income$59,103U.S. Census ACS

Local Uninsured Share16.4%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 57/100 · Caution CMS CCN 451364

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 451364) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-06-09

Validated Rate Rows5,041 (CMS v3.0.0)

File Integrity DigestVerified · CCN 451364

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