Riverside Shore Memorial Hospital
20480 Market Street, Onancock, VA 23417 · 43 Priced Procedures · 76% Patient Recommendation
Typical commercial prices here are +28% above the fair benchmark (1.28×) even after accounting for local nurse/doctor wages and patient complexity.
4-Star CMS clinical quality rating paired with 1.28× fair market pricing.
Loss-Leader / Captive Ancillary Cross-Subsidizer
Riverside Shore Memorial Hospital prices routine shoppable procedures near 1.3× Medicare (p50 1.16×) while skewing captive emergency, lab, and upper-quartile codes to 2.2× Medicare (p75 1.63×, +41% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.96× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 0% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (76/100 safety score) with 76% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (36.3% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.6× markup over Medicare rates
- Captive ER (1.9×) & laboratory (1.7×) services average 1.69× higher multiples than routine shoppable care (1.3×)
- Upper-quartile procedures (Q75 1.63×) jump +41% above the median procedure ratio (Q50 1.16×)
- Unnegotiated chargemaster list prices average 3.8× Medicare (26¢ 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 Riverside Shore Memorial Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 43 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $35,912 | unverified |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $9,829 | 1.2× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $5,626 | 0.9× |
| C-section delivery (full package) CPT Code: 59510 | $3,602 | 1.2× |
| Inguinal hernia repair CPT Code: 49505 | $3,538 | 1.0× |
| Vaginal delivery (full package) CPT Code: 59400 | $3,258 | 1.2× |
| Bunion correction surgery CPT Code: 28296 | $3,253 | 0.9× |
| Cataract surgery with lens implant CPT Code: 66984 | $2,317 | 0.9× |
| Residential mental health treatment HCPCS Code: H2036 | $715 | unverified |
| Injection procedure for pain management HCPCS Code: G0260 | $661 | 0.8× |
| Behavioral health day program HCPCS Code: H2012 | $651 | unverified |
| Rabies immune globulin HCPCS Code: 90375 | $478 | unverified |
| Behavioral health assessment HCPCS Code: H0001 | $326 | 2.1× |
| Mental health services (assessment) HCPCS Code: H0031 | $326 | unverified |
| Behavioral health counseling (per session) HCPCS Code: H0008 | $253 | unverified |
| Behavioral health residential care HCPCS Code: H0011 | $253 | unverified |
| Care planning with family CPT Code: 90887 | $211 | 2.0× |
| Residential substance abuse treatment HCPCS Code: H2035 | $176 | 2.0× |
| Family therapy session CPT Code: 90847 | $161 | 0.9× |
| Behavioral health living support HCPCS Code: H2019 | $176 | unverified |
| Mental health services (therapy) HCPCS Code: H0032 | $130 | 2.0× |
| Review of medical records for care CPT Code: 90889 | $130 | 1.1× |
| Speech therapy (language evaluation) CPT Code: 92507 | $101 | 1.2× |
| Varicella (chickenpox) vaccine HCPCS Code: 90716 | $171 | 0.8× |
| Orthotic fitting and training CPT Code: 97760 | $62 | 1.2× |
Audit a Bill or Quote at Riverside Shore Memorial Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $31,252
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $31,252).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Riverside Shore Memorial Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $19,432 Fair BaseRate ($14,044 Medicare)
Your bill ($86,189) is $66,757 above the denoised Fair BaseRate ($19,432) and 6.1× the $14,044 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Illustrative National Nonprofit Peer Median (36.3% of gross — request this hospital's exact FAP Look-Back AGB percentage)
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. Hospital-specific AGB look-back percentages are published in each facility’s written Financial Assistance Policy (FAP). This figure reflects the national nonprofit peer median benchmark.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)Source: CMS Hospital Care Compare (231 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 Riverside Shore Memorial Hospital.
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.