How many shoppable procedure prices are published for Spotsylvania Regional Medical Center?

Spotsylvania Regional Medical Center in Fredericksburg, VA currently has 119 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Spotsylvania Regional Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Spotsylvania Regional Medical Center's median negotiated commercial rate is 1.6× the regionally adjusted fair BaseRate benchmark.

What is Spotsylvania Regional Medical Center's CMS Care Compare overall star rating?

CMS Care Compare assigns Spotsylvania Regional Medical Center an overall hospital quality rating of 3 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Proprietary 109 Beds · urban Updated: 2026-09-01

Spotsylvania Regional Medical Center

4600 Spotsylvania Parkway, Fredericksburg, VA 22408 · 119 Priced Procedures · 64% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

High Markup · Shop Alternatives

1.64×vs. Fair Market Price

Typical commercial prices here are +64% above the fair benchmark (1.64×) even after accounting for local nurse/doctor wages and patient complexity.

64/100 · Caution

64/100Self-Pay Cash Beats Insurance 2% of the Time

File Completeness50

Price Logic97

Peer Alignment69

Clean Billing86

Real Cash Discount6

High Price · Lower Safety

2-Star CMS clinical quality rating paired with 1.64× fair market pricing.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Spotsylvania Regional Medical Center prices routine shoppable procedures near 2.4× Medicare (p50 1.70×) while skewing captive emergency, lab, and upper-quartile codes to 5.2× Medicare (p75 2.58×, +52% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#65 of 75 in VA · 85th State Percentile#2,817 of 3,385 in U.S. · 83rd National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.00× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 2% of shoppable procedures (25/100 Cash Honesty)
CMS clinical safety score (61/100 safety score) with 64% 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)

Outpatient surgery & OR suites carry a 1.5× markup over Medicare rates
Captive ER (0.7×) & laboratory (1.8×) services average 2.17× higher multiples than routine shoppable care (2.4×)
Upper-quartile procedures (Q75 2.58×) jump +52% above the median procedure ratio (Q50 1.70×)
Unnegotiated chargemaster list prices average 18.1× Medicare (14¢ 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 & ER2.17× Divergence

5.2× Medicare

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

Quantile Tail Spread+52% Upper Tail

Q25 1.00× · Q50 1.70× · Q75 2.58×

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

1.5× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.4× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

0.7× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.8× MedicareGood

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

1.2× MedicareGood

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

2% Cash Edge · 25/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 61/100Elevated

Procedure Prices at Spotsylvania Regional Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 119 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Total hip replacement CPT Code: `27130`	—	$28,931	$13,413	2.2×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$15,496	$19,432	0.8×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$8,048	$8,223	1.0×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$7,433	$6,109	1.2×
Cataract surgery with lens implant CPT Code: `66984`	—	$6,880	$2,540	2.7×
Vaginal delivery (full package) CPT Code: `59400`	—	$5,897	$2,680	2.2×
C-section delivery (full package) CPT Code: `59510`	—	$5,897	$2,975	2.0×
Bunion correction surgery CPT Code: `28296`	—	$5,897	$3,446	1.7×
Inguinal hernia repair CPT Code: `49505`	—	$5,897	$3,629	1.6×
Breast lump removal CPT Code: `19120`	—	$5,871	$3,875	1.5×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$7,442	$4,242	$583	unverified
Colonoscopy with biopsy CPT Code: `45380`	—	$3,074	$1,256	2.4×
Sleep study (overnight, in lab) CPT Code: `95810`	—	$2,735	$1,021	2.7×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$2,550	$981	2.6×
Upper endoscopy with biopsy CPT Code: `43239`	—	$2,550	$987	2.6×
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	—	$2,552	$30,775	0.1×
Blood transfusion CPT Code: `36430`	$4,367	$2,385	$498	4.8×
Injection procedure for pain management HCPCS Code: `G0260`	—	$2,385	$855	2.8×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$2,278	$19,087	0.1×
Behavioral health counseling (per session) HCPCS Code: `H0008`	—	$2,104	$257	unverified
Behavioral health counseling (group) HCPCS Code: `H0009`	—	$2,104	$269	unverified
Behavioral health day treatment HCPCS Code: `H0010`	—	$2,104	$343	unverified
Behavioral health residential care HCPCS Code: `H0011`	—	$2,104	$364	unverified
Ultrasound, leg veins (duplex) CPT Code: `93970`	$2,835	$1,616	$272	unverified
Residential mental health treatment HCPCS Code: `H2036`	—	$1,215	$406	3.0×
MRI, brain (with and without contrast) CPT Code: `70553`	$7,783	$808	$511	1.6×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$5,870	$805	$448	unverified
Hepatitis B immune globulin HCPCS Code: `90371`	$1,160	$748	$151	unverified
Rabies immune globulin HCPCS Code: `90375`	—	$645	$322	2.0×
MRI, knee or other leg joint CPT Code: `73721`	$10,052	$526	$369	1.4×
MRI, lower back (no contrast) CPT Code: `72148`	$7,983	$484	$338	1.4×
MRI, brain (no contrast) CPT Code: `70551`	$7,783	$496	$343	unverified
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$865	$493	$64	unverified
Diagnostic mammogram (both breasts) CPT Code: `77066`	$684	$409	$148	2.8×
CT scan, head (with and without contrast) CPT Code: `70470`	$4,328	$426	$258	unverified
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$4,230	$382	$303	1.3×
Ultrasound, abdomen (limited) CPT Code: `76705`	$2,010	$406	$126	unverified
Ultrasound, pelvis CPT Code: `76856`	$1,813	$386	$130	unverified
Screening mammogram (both breasts) CPT Code: `77067`	$684	$337	$123	2.7×
CT scan, head (with contrast) CPT Code: `70460`	$3,948	$357	$242	unverified
Ultrasound, abdomen (complete) CPT Code: `76700`	$2,920	$360	$134	unverified
CT scan, sinuses CPT Code: `70486`	$4,782	$329	$166	2.0×
CT scan, chest (no contrast) CPT Code: `71250`	$7,818	$352	$167	unverified
CT scan, neck (cervical spine) CPT Code: `72125`	$4,499	$313	$169	1.9×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$6,678	$310	$168	1.8×
CT scan, pelvis CPT Code: `72192`	$3,868	$308	$163	unverified
Ultrasound, thyroid and neck CPT Code: `76536`	$1,526	$305	$132	unverified
Office visit, established patient (20-29 min) CPT Code: `99213`	$488	$312	$87	unverified
CT scan, head (no contrast) CPT Code: `70450`	$3,669	$250	$160	1.6×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$245	$17,936	unverified
X-ray, hip CPT Code: `73502`	$602	$169	$93	1.8×
Breathing treatment (nebulizer) CPT Code: `94640`	$347	$194	$201	1.0×
Speech therapy (language evaluation) CPT Code: `92507`	$444	$178	$86	unverified
X-ray, hand CPT Code: `73130`	$754	$139	$93	1.5×
X-ray, ankle CPT Code: `73610`	$1,009	$136	$93	1.5×
X-ray, shoulder CPT Code: `73030`	$1,116	$131	$92	1.4×
X-ray, lower back CPT Code: `72110`	$1,333	$151	$112	1.3×
X-ray, foot CPT Code: `73630`	$990	$125	$92	1.4×
X-ray, neck (cervical spine) CPT Code: `72040`	$959	$109	$93	1.2×
X-ray, chest (two views) CPT Code: `71046`	$934	$88	$93	0.9×
Typhoid vaccine HCPCS Code: `90675`	$2,070	$890	$347	unverified
Drug screening test HCPCS Code: `G0480`	$1,619	$568	$116	unverified
Pneumococcal vaccine HCPCS Code: `90732`	$1,203	$481	$140	unverified
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$455	$203	2.2×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$1,106	$442	$111	unverified
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$926	$370	$56	unverified
Culture, bacterial CPT Code: `87070`	$555	$250	$9	unverified
Blood test, vitamin D CPT Code: `82306`	$900	$155	$31	unverified
Blood test, PSA (prostate screen) CPT Code: `84153`	$608	$96	$19	5.1×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	—	$101	$27	3.7×
Colorectal cancer screening HCPCS Code: `G0010`	$177	$101	$49	unverified
Blood test, comprehensive metabolic panel CPT Code: `80053`	$1,056	$55	$11	5.0×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$867	$70	$14	5.0×
Hepatitis C antibody test CPT Code: `86803`	$702	$75	$15	5.0×
Blood test, vitamin B12 CPT Code: `82607`	$581	$79	$16	4.9×
Blood test, thyroid (TSH) CPT Code: `84443`	$833	$88	$18	4.9×
Flu vaccine (high dose) HCPCS Code: `90656`	$259	$104	$25	4.2×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$188	$98	$39	unverified
Hepatitis B vaccine HCPCS Code: `90744`	$295	$118	$37	unverified
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$608	$101	$20	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	$364	$72	$86	0.8×
Blood test, ferritin (iron stores) CPT Code: `82728`	$168	$68	$14	unverified
Blood test, calcium CPT Code: `82310`	$347	$27	$5	5.4×
Blood test, creatinine (kidney) CPT Code: `82565`	$216	$27	$5	5.4×
Blood test, clotting time (PTT) CPT Code: `85730`	$287	$32	$6	5.3×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$340	$21	$4	5.3×
Blood test, basic metabolic panel CPT Code: `80048`	$750	$44	$9	4.9×
X-ray, chest (single view) CPT Code: `71045`	$848	$67	$92	0.7×
X-ray, pelvis CPT Code: `72170`	$1,026	$75	$110	0.7×
Blood test, liver function panel CPT Code: `80076`	$654	$43	$9	4.8×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$437	$51	$10	unverified
Urinalysis (automated, with microscopy) CPT Code: `81001`	$270	$17	$3	5.7×
Blood test, amylase CPT Code: `82150`	$434	$34	$7	4.9×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$287	$23	$5	4.6×
Blood test, complete blood count (CBC) CPT Code: `85025`	—	$30	$8	3.8×
Diagnostic procedure preparation HCPCS Code: `G0279`	$59	$53	$35	1.5×
Blood antibody screen CPT Code: `86850`	$350	$51	$46	1.1×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$244	$39	$38	1.0×
Pneumonia vaccine injection HCPCS Code: `G0009`	$87	$50	$49	1.0×
Flu vaccine injection HCPCS Code: `G0008`	$87	$47	$48	1.0×
Behavioral health living support HCPCS Code: `H2019`	—	$33	$34	1.0×
Physical therapy (gait training) CPT Code: `97116`	$170	$31	$33	0.9×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$173	$36	$40	0.9×
Speech therapy (group session) CPT Code: `92508`	—	$24	$27	0.9×
Prosthetic fitting and training CPT Code: `97761`	—	$40	$45	0.9×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$173	$31	$35	0.9×
Occupational therapy (self-care training) CPT Code: `97535`	$147	$33	$38	0.9×
Physical therapy (functional capacity test) CPT Code: `97750`	$191	$33	$38	0.9×
Orthotic fitting and training CPT Code: `97760`	$173	$44	$51	0.9×
Electrical stimulation therapy HCPCS Code: `G0283`	$147	$13	$14	0.9×
Physical therapy (manual therapy) CPT Code: `97140`	$173	$29	$34	0.9×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$13	$25	0.5×
Blood test, lipase CPT Code: `83690`	$491	$36	$7	unverified
Blood test, magnesium CPT Code: `83735`	$360	$35	$7	unverified
Culture, blood CPT Code: `87040`	$622	$54	$11	unverified
Blood test, glucose (blood sugar) CPT Code: `82947`	$440	$21	$4	unverified
Blood test, potassium CPT Code: `84132`	$141	$25	$5	unverified
Blood test, sodium CPT Code: `84295`	$172	$25	$5	unverified
Blood test, hemoglobin CPT Code: `85018`	$72	$12	$3	unverified

Showing top 25 high-impact procedures of 119 total

Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at Spotsylvania Regional Medical Center (Zero PHI Required)

CMS CCN: 490141

CPT 27130

Select Procedure to Audit:

Fair BaseRate™ $13,413

Medicare Rate $13,117

Self-Pay Cash Request Quote

Insurer Median $28,931

1. Amount on Your Bill or Quote ($) Pre-filled with Spotsylvania Regional 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 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 Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Spotsylvania Regional Medical Center's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$56,021 Above Fair BaseRate

Negotiate Toward $13,413 Fair BaseRate ($13,117 Medicare)

Your bill ($69,434) is $56,021 above the denoised Fair BaseRate ($13,413) and 5.3× the $13,117 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) For-Profit / Non-501(c)(3)

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

EIN: 061760818

Public IRS & CMS ownership records classify Spotsylvania Regional Medical Center 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

CMS Overall2/5 Stars (2/5)

Safety Composite61/100

Would Recommend64%

Rated 9 or 10 (HCAHPS)63%

Median ER Wait116 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate3%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionsame

C. diff Hospital-Onset Infectionbetter

CMS Price Transparency Administrative Enforcement Log

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

2025-04-28·administrative_or_closure
Met Requirements
Recorded
2023-12-14·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare (459 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 Quality & Price Benchmark

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Spotsylvania Regional Medical Center.

Price Index: 0.94× regional baseline

Quality: 49/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Humana

-63.1%

Evernorth Behavioral Health

-53.3%

Health Net

+109.1%

Kaiser Permanente

+120.4%

Median Household Income$109,576U.S. Census ACS

Local Uninsured Share6.7%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 64/100 · Caution CMS CCN 490141 EIN 061760818

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 490141) ↗ Verify IRS Form 990 (EIN 061760818) ↗ CMS HCRIS Cost Reports ↗

Published MRF File06-1760818_SPOTSYLVANIA-REGIONAL-MEDICAL-CENTER_standardcharges.json

Publication / Vintage2026-09-01 · 218.80 MB

Validated Rate Rows3,540 (CMS v3.0.0)

File Integrity DigestVerified · CCN 490141

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