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Hospital Profile Critical Access Hospital Government - Hospital District or Authority 25 Beds · rural Updated: 2026-01-14

Seymour Hospital

200 Stadium Drive, Seymour, TX 76380 · 72 Priced Procedures · 77% Patient Recommendation

CMS Overall Rating No CMS Rating
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
1.31×vs. Fair Market Price
Position vs. 1.00× Fair Price+31% 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 +31% above the fair benchmark (1.31×) 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).77/100 · Corroborated
77/100Self-Pay Cash Beats Insurance 56% of the Time
File Completeness61Provenance (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 Logic79Coherence (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 Alignment76Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing72Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount100Cash 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 RatingNot RatedOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety Score71/100Composite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER Wait72 minMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

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

Behavioral Pricing FingerprintUpper-Quartile Spread · +118% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Seymour Hospital prices routine shoppable procedures at 2.4× Medicare (median 0.93× Fair BaseRate) while upper-quartile commercial rates jump +118% to 2.03× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#205 of 307 in TX · 66th State Percentile#2,278 of 3,385 in U.S. · 67th National Percentile
Advantage

Where They're Good (Patient & Payer Edge)

  • Bottom-quartile procedures (Q25) price at 0.89× the peer BaseRate benchmark
  • Self-pay cash beats commercial insurance on 56% of shoppable procedures (99/100 Cash Honesty)
  • CMS clinical safety score (71/100 safety score) with 77% 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 (1.31× 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 0.93× Fair BaseRate (2.4× Medicare), so insured patients should always compare the self-pay cash price before paying.
  • Upper-quartile procedures (Q75 2.03×) jump +118% above the median procedure ratio (Q50 0.93×)
  • Unnegotiated chargemaster list prices average 6.3× Medicare (30¢ true HCRIS cost per $1 gross)
Front-Door ShoppableElective / Imaging
2.4× Medicare

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

Back-Door Captive & ER0.38× Divergence
0.9× Medicare

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

Quantile Tail Spread+118% Upper Tail
Q25 0.89× · Q50 0.93× · Q75 2.03×

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
2.4× MedicareFair
Outpatient Surgery & ORBack-Door Captive
0.7× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
4.7× MedicareWatchout
Back-Door Captive ER VisitsBack-Door Captive
3.5× MedicareElevated
Inpatient Lab & PathologyBack-Door Captive
3.6× MedicareElevated
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
0.8× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
56% Cash Edge · 99/100Good
CMS Clinical Safety & Star ValueIntegrity & Outcomes
3 CMS · 71/100Fair

Procedure Prices at Seymour Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 72 published procedures.

Sort:
Audit a Bill & 501(r) Cap ↓
Procedure & Billing Code This Hospital vs. Fair
Gallbladder removal (laparoscopic)
CPT Code: 47562
 $3,924 unverified
Breast lump removal
CPT Code: 19120
 $2,929 unverified
Colonoscopy with biopsy
CPT Code: 45380
 $1,268 unverified
CT scan, abdomen and pelvis (with contrast)
CPT Code: 74177
 $657 1.5×
MRI, knee or other leg joint
CPT Code: 73721
 $615 1.7×
Inguinal hernia repair
CPT Code: 49505
 $626 0.2×
CT scan, abdomen and pelvis (no contrast)
CPT Code: 74176
 $572 1.9×
CT scan, head (with contrast)
CPT Code: 70460
 $539 2.2×
CT scan, head (with and without contrast)
CPT Code: 70470
 $539 2.1×
CT scan, head (no contrast)
CPT Code: 70450
 $492 3.1×
CT scan, pelvis
CPT Code: 72192
 $492 3.0×
CT scan, sinuses
CPT Code: 70486
 $492 3.0×
CT scan, chest (no contrast)
CPT Code: 71250
 $492 2.9×
CT scan, lower back (lumbar spine)
CPT Code: 72131
 $492 2.9×
CT scan, neck (cervical spine)
CPT Code: 72125
 $492 2.9×
Office visit, established patient (30-39 min)
CPT Code: 99214
 $249 2.0×
New patient office visit (30-44 min)
CPT Code: 99203
 $263 unverified
Ultrasound, abdomen (limited)
CPT Code: 76705
 $205 1.6×
Ultrasound, thyroid and neck
CPT Code: 76536
 $205 1.6×
Physical therapy (manual therapy)
CPT Code: 97140
 $110 3.2×
Physical therapy (therapeutic exercise)
CPT Code: 97110
 $110 3.1×
Physical therapy (neuromuscular re-education)
CPT Code: 97112
 $110 2.9×
Occupational therapy (self-care training)
CPT Code: 97535
 $110 2.9×
Occupational therapy (therapeutic activities)
CPT Code: 97530
 $110 2.8×
Speech therapy (language evaluation)
CPT Code: 92507
 $110 1.3×
Showing top 25 high-impact procedures of 72 total
Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

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

CMS CCN: 451399
CPT 47562
Fair BaseRate™ $6,109
Medicare Rate $6,176
Self-Pay Cash $3,924
Insurer Median $3,924
Pre-filled with Seymour Hospital’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 Save $1,681 Paying Cash

Self-Pay Cash Rate ($3,924) Beats Your Bill

Seymour Hospital's published 45 CFR § 180 self-pay cash rate is $3,924 (vs. $3,924 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target Target: $6,109 Fair BaseRate

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

Your entered amount is at or below the modeled Fair BaseRate benchmark ($6,109).

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 Seymour 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 Composite71/100
Would Recommend77%
Rated 9 or 10 (HCAHPS)85%
Median ER Wait72 min
Left ER Before Seen0%
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 Seymour Hospital. Prior administrative notices do not necessarily reflect current compliance status.

  • 2026-03-09·warning_notice

    Warning Notice

    Recorded

Source: CMS Hospital Care Compare (32 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

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

Price Index: 0.99× regional baseline
Quality: 58/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

GEHA
-47.9%
Median Household Income$42,313U.S. Census ACS
Local Uninsured Share21.5%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 77/100 · Corroborated CMS CCN 451399

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 451399) ↗ CMS HCRIS Cost Reports ↗
Published MRF FileCMS_45_CFR_180_FILING.json
Publication / Vintage2026-01-14
Validated Rate Rows1,585 (CMS v3.0.0)
File Integrity DigestVerified · CCN 451399

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