How many shoppable procedure prices are published for Palacios Community Medical Center?

Palacios Community Medical Center in Palacios, TX currently has 98 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Palacios Community Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Palacios Community Medical Center's median negotiated commercial rate is 1.9× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Voluntary non-profit - Private 17 Beds · rural Updated: 2026-02-01

Palacios Community Medical Center

311 Green Avenue, Palacios, TX 77465 · 98 Priced Procedures

CMS Overall Rating No CMS Rating

High Markup · Shop Alternatives

1.90×vs. Fair Market Price

Typical commercial prices here are +90% above the fair benchmark (1.90×) even after accounting for local nurse/doctor wages and patient complexity.

57/100 · Caution

57/100Self-Pay Cash Beats Insurance 6% of the Time

File Completeness33

Price Logic83

Peer Alignment75

Clean Billing80

Real Cash Discount6

High-Markup · Check Safety

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

Behavioral Pricing FingerprintHigh-HHI Market Leverage

Consolidated System Premium Pricer

Operating in a concentrated regional market (CBSA HHI 9,189), Palacios Community Medical Center commands a 1.90× BaseRate commercial premium across insurers. Self-pay cash quotes, in-state peer hospitals, and freestanding outpatient facilities offer critical leverage against consolidated system pricing.

#263 of 307 in TX · 85th State Percentile#3,025 of 3,385 in U.S. · 89th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.40× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 6% of shoppable procedures (25/100 Cash Honesty)
CMS clinical safety score (85/100 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 (53.0% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 2.5× markup over Medicare rates
Commercial insurance median sits at 1.90× Fair BaseRate (2.6× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 2.20×) jump +16% above the median procedure ratio (Q50 1.90×)
Consolidated metro market (HHI 9,189) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

2.6× Medicare

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

Back-Door Captive & ER0.73× Divergence

1.9× Medicare

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

Quantile Tail Spread+16% Upper Tail

Q25 1.40× · Q50 1.90× · Q75 2.20×

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

2.6× MedicareFair

Outpatient Surgery & ORBack-Door Captive

2.5× MedicareFair

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

2.7× MedicareFair

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

1.2× MedicareGood

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

6% Cash Edge · 25/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 85/100Good

Procedure Prices at Palacios Community Medical Center

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
Trauma team activation HCPCS Code: `G0390`	$3,000	$3,000	$1,453	2.1×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$12,800	$2,049	$6,109	0.3×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,870	$1,445	$448	3.2×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,430	$1,430	$303	unverified
Sleep study (overnight, in lab) CPT Code: `95810`	$3,805	$1,400	$1,021	1.4×
Inguinal hernia repair CPT Code: `49505`	$7,805	$1,348	$3,629	0.4×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,090	$1,254	$511	2.5×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$5,512	$1,255	$3,372	0.4×
Bunion correction surgery CPT Code: `28296`	$10,540	$1,211	$3,446	0.4×
Cataract surgery with lens implant CPT Code: `66984`	$5,115	$1,145	$2,540	0.5×
Breast lump removal CPT Code: `19120`	$8,536	$1,122	$3,875	0.3×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,210	$1,118	$168	unverified
CT scan, head (with and without contrast) CPT Code: `70470`	$1,870	$1,042	$258	4.0×
CT scan, head (with contrast) CPT Code: `70460`	$1,650	$932	$242	3.9×
Blood transfusion CPT Code: `36430`	$924	$924	$498	1.9×
CT scan, head (no contrast) CPT Code: `70450`	$1,430	$760	$160	4.8×
CT scan, sinuses CPT Code: `70486`	$1,320	$760	$166	4.6×
CT scan, chest (no contrast) CPT Code: `71250`	$784	$784	$167	unverified
MRI, lower back (no contrast) CPT Code: `72148`	$1,980	$755	$338	2.2×
MRI, brain (no contrast) CPT Code: `70551`	$1,430	$755	$343	2.2×
Injection procedure for pain management HCPCS Code: `G0260`	$766	$766	$855	0.9×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,320	$664	$169	3.9×
CT scan, pelvis CPT Code: `72192`	$1,210	$609	$163	3.7×
Ultrasound, abdomen (complete) CPT Code: `76700`	$851	$470	$134	3.5×
Upper endoscopy with biopsy CPT Code: `43239`	$2,937	$485	$987	0.5×
Ultrasound, abdomen (limited) CPT Code: `76705`	$535	$421	$126	3.3×
Ultrasound, thyroid and neck CPT Code: `76536`	$535	$440	$132	3.3×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,151	$458	$583	0.8×
Psychotherapy session (60 minutes) CPT Code: `90837`	$400	$400	$181	2.2×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$693	$423	$272	1.6×
Colonoscopy with biopsy CPT Code: `45380`	$2,072	$365	$1,256	0.3×
Colonoscopy (diagnostic) CPT Code: `45378`	$2,025	$336	$981	0.3×
X-ray, hand CPT Code: `73130`	$383	$344	$93	unverified
Ultrasound, pelvis CPT Code: `76856`	$641	$290	$130	2.2×
X-ray, hip CPT Code: `73502`	$307	$307	$93	unverified
X-ray, lower back CPT Code: `72110`	$520	$273	$112	2.4×
Psychotherapy session (45 minutes) CPT Code: `90834`	$285	$285	$166	1.7×
Breathing treatment (nebulizer) CPT Code: `94640`	$397	$285	$201	1.4×
X-ray, pelvis CPT Code: `72170`	$344	$273	$110	unverified
X-ray, foot CPT Code: `73630`	$383	$234	$92	2.5×
X-ray, neck (cervical spine) CPT Code: `72040`	$374	$235	$93	2.5×
X-ray, shoulder CPT Code: `73030`	$296	$201	$92	2.2×
X-ray, ankle CPT Code: `73610`	$383	$201	$93	2.2×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$370	$213	$148	1.4×
X-ray, chest (single view) CPT Code: `71045`	$132	$132	$92	1.4×
New patient office visit (30-44 min) CPT Code: `99203`	$154	$154	$110	1.4×
Screening mammogram (both breasts) CPT Code: `77067`	$220	$145	$123	1.2×
Office visit, established patient (30-39 min) CPT Code: `99214`	$132	$132	$123	1.1×
Psychiatric evaluation (first visit) CPT Code: `90791`	$376	$145	$185	0.8×
Physical therapy (functional capacity test) CPT Code: `97750`	$440	$92	$38	2.4×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$145	$86	$40	2.1×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$186	$104	$64	1.6×
Office visit, established patient (20-29 min) CPT Code: `99213`	$88	$88	$87	1.0×
Pneumococcal vaccine HCPCS Code: `90732`	$238	$238	$140	1.7×
Drug screening test HCPCS Code: `G0480`	$101	$101	$116	0.9×
Blood antibody screen CPT Code: `86850`	$99	$99	$46	unverified
Flu vaccine injection HCPCS Code: `G0008`	$71	$71	$48	1.5×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$84	$84	$20	unverified
Blood test, average blood sugar (A1c) CPT Code: `83036`	$44	$44	$10	4.4×
Electrical stimulation therapy HCPCS Code: `G0283`	$84	$39	$14	2.8×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$156	$59	$38	1.6×
Orthotic fitting and training CPT Code: `97760`	$165	$64	$51	1.3×
Blood test, ferritin (iron stores) CPT Code: `82728`	$53	$28	$14	2.0×
Physical therapy (manual therapy) CPT Code: `97140`	$134	$53	$34	1.6×
Blood test, lipase CPT Code: `83690`	$68	$14	$7	2.0×
Blood test, magnesium CPT Code: `83735`	$135	$14	$7	2.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$107	$37	$19	1.9×
Blood test, sodium CPT Code: `84295`	$19	$10	$5	2.0×
Blood test, thyroid (TSH) CPT Code: `84443`	$164	$34	$18	1.9×
Blood test, vitamin D CPT Code: `82306`	$314	$56	$31	1.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$122	$57	$35	1.6×
Occupational therapy (self-care training) CPT Code: `97535`	$125	$60	$38	1.6×
Physical therapy (gait training) CPT Code: `97116`	$123	$51	$33	1.5×
Pneumonia vaccine injection HCPCS Code: `G0009`	$71	$71	$49	1.4×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$127	$37	$56	0.7×
Hospital observation (per hour) HCPCS Code: `G0378`	$41	$38	$86	0.4×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$65	$6	$3	2.0×
Blood test, calcium CPT Code: `82310`	$73	$10	$5	2.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$20	$10	$5	2.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$48	$8	$4	2.0×
Blood test, hemoglobin CPT Code: `85018`	$8	$6	$3	2.0×
Hepatitis C antibody test CPT Code: `86803`	$156	$29	$15	1.9×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$114	$27	$14	1.9×
Culture, blood CPT Code: `87040`	$79	$21	$11	1.9×
Blood test, basic metabolic panel CPT Code: `80048`	$84	$17	$9	1.9×
Culture, bacterial CPT Code: `87070`	$83	$17	$9	1.9×
Blood test, vitamin B12 CPT Code: `82607`	$113	$30	$16	1.9×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$77	$17	$11	1.5×
X-ray, chest (two views) CPT Code: `71046`	$41	$41	$93	unverified
Blood test, amylase CPT Code: `82150`	$102	$13	$7	1.9×
Blood test, potassium CPT Code: `84132`	$21	$9	$5	1.8×
Blood test, clotting time (PTT) CPT Code: `85730`	$92	$10	$6	1.7×
Blood test, glucose (blood sugar) CPT Code: `82947`	$13	$6	$4	1.5×
Blood test, complete blood count (CBC) CPT Code: `85025`	$56	$12	$8	1.5×
Blood test, liver function panel CPT Code: `80076`	$46	$13	$9	1.4×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$23	$7	$5	1.4×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$85	$26	$25	1.0×
Colorectal cancer screening HCPCS Code: `G0010`	$14	$14	$49	0.3×

Showing top 25 high-impact procedures of 98 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 53.0%

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

CMS CCN: 451332

CPT G0390

Select Procedure to Audit:

Fair BaseRate™ $1,453

Medicare Rate $1,362

Self-Pay Cash $3,000

Insurer Median $3,000

1. Amount on Your Bill or Quote ($) Pre-filled with Palacios Community Medical Center’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: $1,590 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $1,590

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (53.0% of gross = $1,590).

Step 2 · Cash vs. Insurance Arbitrage Published Cash: $3,000

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Palacios Community Medical Center's published 45 CFR § 180 self-pay cash rate is $3,000 (vs. $3,000 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$1,547 Above Fair BaseRate

Negotiate Toward $1,453 Fair BaseRate ($1,362 Medicare)

Your bill ($3,000) is $1,547 above the denoised Fair BaseRate ($1,453) and 2.2× the $1,362 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: 760698013

Filing Period: 202512

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 (53.0% 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 Composite85/100

Median ER Wait78 min

Left ER Before Seen0%

CMS Price Transparency Administrative Enforcement Log

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

2023-12-04·administrative_or_closure
Closure Notice
Recorded
2023-07-26·cap_corrective_action
CAP Request
Recorded
2023-04-11·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.

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 Palacios Community Medical Center.

Price Index: 0.91× regional baseline

Quality: 57/100 CMS composite

Median Household Income$55,174U.S. Census ACS

Local Uninsured Share17.9%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 451332 EIN 760698013

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 451332) ↗ Verify IRS Form 990 (EIN 760698013) ↗ CMS HCRIS Cost Reports ↗

Published MRF Fileurl

Publication / Vintage2026-02-01 · 1.91 MB

Validated Rate Rows1,025 (CMS v2.0.0)

File Integrity DigestVerified · CCN 451332

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