UT Health East Texas Carthage Hospital
409 Cottage Rd, Carthage, TX 75633 · 85 Priced Procedures · 74% Patient Recommendation
Typical commercial prices here match the fair market benchmark (1.00×) after accounting for local nurse/doctor wages and patient complexity.
5-Star CMS clinical quality rating paired with 1.00× fair market pricing.
Specialty Drug & Surgical Margin Engine
UT Health East Texas Carthage Hospital concentrates commercial margin in outpatient surgical suites (4.2× Medicare) and specialty drug infusions (4.5× Medicare) relative to routine diagnostics (21.1×). Comparing freestanding ambulatory surgery centers or specialty pharmacy options before treatment yields substantial savings.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.78× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 100% of shoppable procedures (99/100 Cash Honesty)
- 5-Star CMS clinical rating with 74% patient recommendation (71/100 safety score)
- Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 4.2× markup over Medicare rates
- Commercial insurance median sits at 1.00× Fair BaseRate (13.3× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 1.28×) jump +28% above the median procedure ratio (Q50 1.00×)
- Unnegotiated chargemaster list prices average 21.0× Medicare (21¢ true HCRIS cost per $1 gross)
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at UT Health East Texas Carthage Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 85 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $1,043 | 2.3× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $1,037 | 2.0× |
| MRI, knee or other leg joint CPT Code: 73721 | $958 | 2.6× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $799 | 2.6× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $803 | 0.8× |
| MRI, lower back (no contrast) CPT Code: 72148 | $767 | 2.3× |
| MRI, brain (no contrast) CPT Code: 70551 | $767 | 2.2× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $773 | 1.3× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $704 | 2.7× |
| CT scan, head (with contrast) CPT Code: 70460 | $621 | 2.6× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $557 | 2.0× |
| Trauma team activation HCPCS Code: G0390 | $579 | 0.4× |
| CT scan, chest (no contrast) CPT Code: 71250 | $533 | 3.2× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $533 | 3.2× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $486 | 0.5× |
| Colonoscopy with biopsy CPT Code: 45380 | $504 | 0.4× |
| CT scan, head (no contrast) CPT Code: 70450 | $475 | 3.0× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $475 | 2.8× |
| CT scan, pelvis CPT Code: 72192 | $426 | 2.6× |
| CT scan, sinuses CPT Code: 70486 | $404 | 2.4× |
| Upper endoscopy with biopsy CPT Code: 43239 | $332 | 0.3× |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $306 | 2.3× |
| X-ray, lower back CPT Code: 72110 | $198 | 1.8× |
| Ultrasound, pelvis CPT Code: 76856 | $185 | 1.4× |
| X-ray, hand CPT Code: 73130 | $122 | 1.3× |
Audit a Bill or Quote at UT Health East Texas Carthage Hospital (Zero PHI Required)
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.
Self-Pay Cash Rate ($1,043) Beats Your Bill
UT Health East Texas Carthage Hospital's published 45 CFR § 180 self-pay cash rate is $1,043 (vs. $1,043 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $448 Fair BaseRate ($356 Medicare)
Your bill ($10,434) is $9,986 above the denoised Fair BaseRate ($448) and 29.3× the $356 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Public IRS & CMS ownership records classify UT Health East Texas Carthage 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.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare (70 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for UT Health East Texas Carthage Hospital.
Notable Payer Contract Outliers (SVD Matrix Anomalies)
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
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.