How many shoppable procedure prices are published for Stephens Memorial Hospital?

Stephens Memorial Hospital in Breckenridge, TX currently has 94 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

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

Across scored shoppable procedures, Stephens Memorial Hospital's median negotiated commercial rate is 2.3× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Government - Hospital District or Authority Updated: 2026-09-24

Stephens Memorial Hospital

200 South Geneva Street, Breckenridge, TX 76424 · 94 Priced Procedures

CMS Overall Rating No CMS Rating

High Markup · Shop Alternatives

2.34×vs. Fair Market Price

Typical commercial prices here are +134% above the fair benchmark (2.34×) even after accounting for local nurse/doctor wages and patient complexity.

74/100 · Corroborated

74/100Self-Pay Cash Beats Insurance 58% of the Time

File Completeness85

Price Logic48

Peer Alignment79

Clean Billing67

Real Cash Discount100

High-Markup · Check Safety

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

Behavioral Pricing FingerprintHigh Insurer Rate · Deep Cash Discount

Cash-Arbitrage Bifurcated Pricer

Stephens Memorial Hospital maintains elevated commercial insurance contracts (2.34× Fair BaseRate) while offering direct self-pay cash discounts that beat commercial negotiated medians on 58% of procedures. High-deductible and uninsured patients should always request the self-pay cash rate prior to billing.

#284 of 307 in TX · 92nd State Percentile#3,215 of 3,385 in U.S. · 94th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.39× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 58% of shoppable procedures (99/100 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 (59.8% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.2× markup over Medicare rates
Commercial insurance median sits at 2.51× Fair BaseRate (2.5× Medicare), so insured patients should always compare the self-pay cash price before paying.
Even at low-cost facilities (2.34× 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.
Unnegotiated chargemaster list prices average 7.7× Medicare (25¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

2.5× Medicare

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

Back-Door Captive & ER0.96× Divergence

2.4× Medicare

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

Quantile Tail Spread+6% Upper Tail

Q25 1.39× · Q50 2.51× · Q75 2.67×

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

2.5× MedicareFair

Outpatient Surgery & ORBack-Door Captive

1.2× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.0× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.0× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.4× MedicareGood

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

0.7× MedicareGood

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

58% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 85/100Good

Procedure Prices at Stephens Memorial Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 94 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`	$7,373	$4,328	$6,109	0.7×
Inguinal hernia repair CPT Code: `49505`	$4,800	$2,752	$3,629	0.8×
Breast lump removal CPT Code: `19120`	$3,554	$2,603	$3,875	0.7×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$4,459	$2,460	$3,372	0.7×
Bunion correction surgery CPT Code: `28296`	$4,594	$2,460	$3,446	0.7×
Cataract surgery with lens implant CPT Code: `66984`	$3,775	$1,840	$2,540	0.7×
Sleep study (overnight, in lab) CPT Code: `95810`	$2,967	$1,513	$1,021	1.5×
Trauma team activation HCPCS Code: `G0390`	$1,530	$1,530	$1,453	1.1×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,005	$1,184	$448	2.6×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,857	$1,184	$511	2.3×
Colonoscopy with biopsy CPT Code: `45380`	$1,363	$918	$1,256	0.7×
MRI, lower back (no contrast) CPT Code: `72148`	$1,114	$876	$338	2.6×
MRI, brain (no contrast) CPT Code: `70551`	$1,114	$876	$343	2.6×
MRI, knee or other leg joint CPT Code: `73721`	$1,114	$876	$369	2.4×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$2,398	$750	$303	2.5×
Upper endoscopy with biopsy CPT Code: `43239`	$1,273	$718	$987	0.7×
CT scan, head (with contrast) CPT Code: `70460`	$2,130	$685	$242	2.8×
CT scan, head (with and without contrast) CPT Code: `70470`	$2,423	$685	$258	2.7×
Colonoscopy (diagnostic) CPT Code: `45378`	$1,297	$699	$981	0.7×
Blood transfusion CPT Code: `36430`	$546	$546	$498	1.1×
CT scan, head (no contrast) CPT Code: `70450`	$1,372	$421	$160	2.6×
CT scan, pelvis CPT Code: `72192`	$928	$421	$163	2.6×
CT scan, sinuses CPT Code: `70486`	$1,003	$421	$166	2.5×
CT scan, chest (no contrast) CPT Code: `71250`	$1,195	$421	$167	2.5×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,077	$421	$168	2.5×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,244	$421	$169	2.5×
Ultrasound, abdomen (limited) CPT Code: `76705`	$432	$379	$126	3.0×
Ultrasound, pelvis CPT Code: `76856`	$642	$379	$130	2.9×
Ultrasound, thyroid and neck CPT Code: `76536`	$385	$379	$132	2.9×
Ultrasound, abdomen (complete) CPT Code: `76700`	$330	$379	$134	2.8×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,036	$388	$272	1.4×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$568	$409	$583	0.7×
X-ray, shoulder CPT Code: `73030`	$202	$270	$92	unverified
X-ray, hand CPT Code: `73130`	$210	$270	$93	unverified
X-ray, hip CPT Code: `73502`	$237	$270	$93	unverified
X-ray, foot CPT Code: `73630`	$276	$270	$92	unverified
New patient office visit (30-44 min) CPT Code: `99203`	$175	$234	$110	2.1×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$229	$229	$148	1.5×
Screening mammogram (both breasts) CPT Code: `77067`	$191	$191	$123	1.6×
Orthotic fitting and training CPT Code: `97760`	$102	$147	$51	2.9×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$133	$166	$64	2.6×
X-ray, neck (cervical spine) CPT Code: `72040`	$162	$162	$93	unverified
X-ray, lower back CPT Code: `72110`	$171	$171	$112	unverified
Speech therapy (language evaluation) CPT Code: `92507`	$118	$118	$86	1.4×
Office visit, established patient (30-39 min) CPT Code: `99214`	$217	$141	$123	1.1×
X-ray, chest (single view) CPT Code: `71045`	$119	$119	$92	unverified
X-ray, chest (two views) CPT Code: `71046`	$137	$137	$93	unverified
X-ray, ankle CPT Code: `73610`	$132	$132	$93	unverified
Physical therapy (manual therapy) CPT Code: `97140`	$67	$86	$34	2.5×
Diagnostic procedure preparation HCPCS Code: `G0279`	$100	$85	$35	2.4×
Office visit, established patient (20-29 min) CPT Code: `99213`	$161	$88	$87	1.0×
X-ray, pelvis CPT Code: `72170`	$105	$105	$110	unverified
Blood test, comprehensive metabolic panel CPT Code: `80053`	$186	$186	$11	16.9×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$128	$128	$14	9.1×
Blood test, amylase CPT Code: `82150`	$91	$91	$7	13.0×
Blood test, liver function panel CPT Code: `80076`	$88	$88	$9	9.8×
Blood test, ferritin (iron stores) CPT Code: `82728`	$109	$109	$14	7.8×
Blood antibody screen CPT Code: `86850`	$103	$134	$46	unverified
Hepatitis C antibody test CPT Code: `86803`	$107	$107	$15	7.1×
Blood test, vitamin B12 CPT Code: `82607`	$108	$108	$16	6.8×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$115	$115	$20	5.8×
Blood test, glucose (blood sugar) CPT Code: `82947`	$72	$72	$4	18.0×
Pneumonia vaccine injection HCPCS Code: `G0009`	$82	$82	$49	1.7×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$53	$53	$5	10.6×
Blood test, complete blood count (CBC) CPT Code: `85025`	$77	$77	$8	9.6×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$83	$83	$10	8.3×
Blood test, creatinine (kidney) CPT Code: `82565`	$54	$54	$5	10.8×
Occupational therapy (self-care training) CPT Code: `97535`	$69	$69	$38	1.8×
Flu vaccine injection HCPCS Code: `G0008`	$82	$72	$48	1.5×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$107	$78	$56	1.4×
Blood test, calcium CPT Code: `82310`	$49	$49	$5	9.8×
Blood test, potassium CPT Code: `84132`	$39	$39	$5	7.8×
Blood test, lipase CPT Code: `83690`	$48	$48	$7	6.9×
Culture, blood CPT Code: `87040`	$66	$66	$11	6.0×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$72	$72	$38	1.9×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$66	$66	$40	1.6×
Blood test, sodium CPT Code: `84295`	$30	$30	$5	6.0×
Blood test, magnesium CPT Code: `83735`	$41	$41	$7	5.9×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$50	$50	$35	1.4×
Physical therapy (functional capacity test) CPT Code: `97750`	$53	$53	$38	1.4×
Physical therapy (gait training) CPT Code: `97116`	$44	$44	$33	1.3×
Breathing treatment (nebulizer) CPT Code: `94640`	$61	$61	$201	unverified
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$31	$11	$4	2.8×
Blood test, clotting time (PTT) CPT Code: `85730`	$55	$16	$6	2.7×
Culture, bacterial CPT Code: `87070`	$91	$23	$9	2.6×
Blood test, thyroid (TSH) CPT Code: `84443`	$154	$35	$18	1.9×
Blood test, PSA (prostate screen) CPT Code: `84153`	$121	$35	$19	1.8×
Blood test, vitamin D CPT Code: `82306`	$182	$41	$31	1.3×
Drug screening test HCPCS Code: `G0480`	$52	$52	$116	0.4×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$43	$9	$3	3.0×
Blood test, basic metabolic panel CPT Code: `80048`	$130	$23	$9	2.6×
Blood test, hemoglobin CPT Code: `85018`	$32	$6	$3	2.0×
Speech therapy (group session) CPT Code: `92508`	$25	$25	$27	0.9×
Hospital observation (per hour) HCPCS Code: `G0378`	$21	$21	$86	0.2×

Showing top 25 high-impact procedures of 94 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 59.9%

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

CMS CCN: 671302

CPT 47562

Select Procedure to Audit:

Fair BaseRate™ $6,109

Medicare Rate $6,176

Self-Pay Cash $7,373

Insurer Median $4,328

1. Amount on Your Bill or Quote ($) Pre-filled with Stephens 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 501(r) AGB Cap: $6,304 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $6,304

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (59.9% of gross = $6,304).

Step 2 · Cash vs. Insurance Arbitrage Save $3,160 Paying Cash

Self-Pay Cash Rate ($7,373) Beats Your Bill

Stephens Memorial Hospital's published 45 CFR § 180 self-pay cash rate is $7,373 (vs. $4,328 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$4,424 Above Fair BaseRate

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

Your bill ($10,533) is $4,424 above the denoised Fair BaseRate ($6,109) and 1.7× 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) 501(c)(3) Nonprofit Hospital

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

EIN: 462931328

Filing Period: 197112

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 (59.9% 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 Wait106 min

CMS Price Transparency Administrative Enforcement Log

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

2026-03-11·warning_notice
Warning Notice
Recorded
2023-08-01·administrative_or_closure
Closure Notice
Recorded
2023-04-13·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

Higher-Quality, Above-Median Price Tier

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

Price Index: 1.35× regional baseline

Quality: 54/100 CMS composite

Median Household Income$54,695U.S. Census ACS

Local Uninsured Share14.4%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 74/100 · Corroborated CMS CCN 671302 EIN 462931328

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 671302) ↗ Verify IRS Form 990 (EIN 462931328) ↗ CMS HCRIS Cost Reports ↗

Published MRF File462931328_stephens-memorial-hospital_standardcharges.csv

Publication / Vintage2026-09-24 · 30.32 MB

Validated Rate Rows1,226 (CMS v3.0.0)

File Integrity Digestd808662cc67f04807842…

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