How many shoppable procedure prices are published for Astria Toppenish Hospital?

Astria Toppenish Hospital in Toppenish, WA currently has 105 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Astria Toppenish Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Astria Toppenish Hospital's median negotiated commercial rate is 0.9× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 47 Beds · urban Updated: 4/1/2026

Astria Toppenish Hospital

502 W Fourth Ave, Toppenish, WA 98948 · 105 Priced Procedures · 81% Patient Recommendation

CMS Overall Rating No CMS Rating

Near Fair BaseRate Benchmark

0.95×vs. Fair Market Price

Typical commercial prices here are 5% below the fair benchmark (0.95×) after accounting for local nurse/doctor wages and patient complexity.

84/100 · Corroborated

84/100Self-Pay Cash Beats Insurance 53% of the Time

File Completeness85

Price Logic81

Peer Alignment66

Clean Billing89

Real Cash Discount100

Regional Value Leader

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

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Astria Toppenish Hospital prices shoppable and inpatient services (1.1× to 1.0× Medicare, divergence 0.91×) in alignment with regional hospital peers (0.95× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#13 of 58 in WA · 20th State Percentile#1,008 of 3,385 in U.S. · 29th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 5% below peer Fair BaseRate (0.95×)
Self-pay cash beats commercial insurance on 53% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (71/100 safety score) with 81% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (36.8% 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 0.95× Fair BaseRate (1.1× Medicare), so insured patients should always compare the self-pay cash price before paying.
Even at low-cost facilities (0.95× 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.
Consolidated metro market (HHI 7,568) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.1× Medicare

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

Back-Door Captive & ER0.91× Divergence

1.0× Medicare

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

Quantile Tail Spread+5% Upper Tail

Q25 0.87× · Q50 0.95× · Q75 1.00×

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

1.1× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.2× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.3× MedicareFair

Back-Door Captive ER VisitsBack-Door Captive

1.4× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

2.9× MedicareFair

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

0.8× MedicareGood

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

53% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 71/100Fair

Procedure Prices at Astria Toppenish Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 105 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`	$4,544	$4,544	$13,413	0.3×
Total knee replacement CPT Code: `27447`	$3,290	$3,290	$13,523	0.2×
C-section delivery (full package) CPT Code: `59510`	$3,008	$2,396	$2,975	0.8×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$2,345	$2,345	$6,109	0.4×
Vaginal delivery (full package) CPT Code: `59400`	$2,873	$1,995	$2,680	0.7×
Bunion correction surgery CPT Code: `28296`	$1,951	$1,951	$3,446	0.6×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$1,695	$1,695	$3,372	0.5×
Colonoscopy with biopsy CPT Code: `45380`	$1,674	$1,204	$1,256	1.0×
Inguinal hernia repair CPT Code: `49505`	$1,152	$1,152	$3,629	0.3×
Sleep study (overnight, in lab) CPT Code: `95810`	$2,737	$1,066	$1,021	unverified
Breast lump removal CPT Code: `19120`	$1,007	$1,007	$3,875	0.3×
Colonoscopy (diagnostic) CPT Code: `45378`	$1,335	$932	$981	1.0×
Upper endoscopy with biopsy CPT Code: `43239`	$1,385	$925	$987	0.9×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,278	$563	$583	1.0×
Blood transfusion CPT Code: `36430`	$1,188	$443	$498	0.9×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$5,584	$392	$448	0.9×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,064	$402	$511	0.8×
Office visit, established patient (30-39 min) CPT Code: `99214`	$245	$260	$123	2.1×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$3,869	$285	$303	0.9×
CT scan, head (no contrast) CPT Code: `70450`	$1,832	$285	$160	unverified
CT scan, head (with contrast) CPT Code: `70460`	$2,482	$285	$242	unverified
CT scan, head (with and without contrast) CPT Code: `70470`	$2,840	$285	$258	unverified
Ultrasound, leg veins (duplex) CPT Code: `93970`	$823	$250	$272	0.9×
MRI, lower back (no contrast) CPT Code: `72148`	$938	$250	$338	0.7×
MRI, brain (no contrast) CPT Code: `70551`	$733	$250	$343	0.7×
MRI, knee or other leg joint CPT Code: `73721`	$686	$250	$369	0.7×
Office visit, established patient (20-29 min) CPT Code: `99213`	$233	$248	$87	unverified
Psychiatric evaluation (first visit) CPT Code: `90791`	$183	$215	$185	1.2×
Breathing treatment (nebulizer) CPT Code: `94640`	$437	$218	$201	1.1×
Psychological testing evaluation CPT Code: `96136`	$200	$200	$128	unverified
New patient office visit (30-44 min) CPT Code: `99203`	$157	$167	$110	1.5×
Psychotherapy session (45 minutes) CPT Code: `90834`	$120	$163	$166	1.0×
Family therapy session CPT Code: `90847`	$148	$163	$173	0.9×
Psychotherapy session (60 minutes) CPT Code: `90837`	$176	$163	$181	0.9×
Care planning with family CPT Code: `90887`	$90	$136	$107	1.3×
Ultrasound, abdomen (complete) CPT Code: `76700`	$749	$151	$134	unverified
Ultrasound, pelvis CPT Code: `76856`	$696	$151	$130	unverified
X-ray, pelvis CPT Code: `72170`	$553	$112	$110	1.0×
X-ray, chest (single view) CPT Code: `71045`	$737	$93	$92	1.0×
X-ray, shoulder CPT Code: `73030`	$831	$93	$92	1.0×
X-ray, foot CPT Code: `73630`	$757	$93	$92	1.0×
X-ray, chest (two views) CPT Code: `71046`	$672	$93	$93	1.0×
X-ray, neck (cervical spine) CPT Code: `72040`	$956	$93	$93	1.0×
X-ray, lower back CPT Code: `72110`	$1,629	$112	$112	1.0×
X-ray, hand CPT Code: `73130`	$712	$93	$93	1.0×
X-ray, hip CPT Code: `73502`	$753	$93	$93	1.0×
X-ray, ankle CPT Code: `73610`	$762	$93	$93	1.0×
Ultrasound, abdomen (limited) CPT Code: `76705`	$386	$112	$126	0.9×
Ultrasound, thyroid and neck CPT Code: `76536`	$391	$112	$132	0.8×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$674	$116	$148	0.8×
Screening mammogram (both breasts) CPT Code: `77067`	$374	$96	$123	0.8×
CT scan, pelvis CPT Code: `72192`	$2,205	$112	$163	0.7×
CT scan, sinuses CPT Code: `70486`	$739	$112	$166	0.7×
CT scan, chest (no contrast) CPT Code: `71250`	$2,306	$112	$167	0.7×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$2,339	$112	$168	0.7×
CT scan, neck (cervical spine) CPT Code: `72125`	$2,066	$112	$169	0.7×
Typhoid vaccine HCPCS Code: `90675`	$185	$260	$347	0.7×
Culture, bacterial CPT Code: `87070`	$280	$280	$9	unverified
Pneumococcal vaccine HCPCS Code: `90732`	$138	$138	$140	1.0×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$285	$62	$64	1.0×
Speech therapy (language evaluation) CPT Code: `92507`	$300	$78	$86	0.9×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$124	$101	$203	0.5×
Blood antibody screen CPT Code: `86850`	$171	$55	$46	1.2×
Orthotic fitting and training CPT Code: `97760`	$120	$49	$51	1.0×
Prosthetic fitting and training CPT Code: `97761`	$116	$43	$45	1.0×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$125	$38	$40	0.9×
Review of medical records for care CPT Code: `90889`	$45	$61	$114	0.5×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$235	$11	$11	1.0×
Blood test, calcium CPT Code: `82310`	$61	$5	$5	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$73	$5	$5	1.0×
Blood test, vitamin D CPT Code: `82306`	$152	$30	$31	1.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$38	$3	$3	1.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	$107	$14	$14	1.0×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$211	$13	$14	0.9×
Physical therapy (functional capacity test) CPT Code: `97750`	$151	$35	$38	0.9×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$156	$34	$38	0.9×
Blood test, glucose (blood sugar) CPT Code: `82947`	$31	$4	$4	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$142	$10	$10	1.0×
Blood test, basic metabolic panel CPT Code: `80048`	$142	$8	$9	0.9×
Blood test, liver function panel CPT Code: `80076`	$77	$8	$9	0.9×
Occupational therapy (self-care training) CPT Code: `97535`	$98	$33	$38	0.9×
Blood test, lipase CPT Code: `83690`	$92	$7	$7	1.0×
Blood test, magnesium CPT Code: `83735`	$65	$7	$7	1.0×
Blood test, potassium CPT Code: `84132`	$66	$5	$5	1.0×
Blood test, sodium CPT Code: `84295`	$64	$5	$5	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$48	$4	$4	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$119	$8	$8	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$69	$6	$6	1.0×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$31	$24	$25	1.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$309	$18	$19	0.9×
Blood test, thyroid (TSH) CPT Code: `84443`	$47	$17	$18	0.9×
Blood test, vitamin B12 CPT Code: `82607`	$100	$15	$16	0.9×
Hepatitis C antibody test CPT Code: `86803`	$120	$14	$15	0.9×
Speech therapy (group session) CPT Code: `92508`	$144	$25	$27	0.9×
Culture, blood CPT Code: `87040`	$171	$10	$11	0.9×
Physical therapy (gait training) CPT Code: `97116`	$125	$30	$33	0.9×
Blood test, amylase CPT Code: `82150`	$17	$6	$7	0.9×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$125	$30	$35	0.9×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$20	$4	$5	0.8×
Physical therapy (manual therapy) CPT Code: `97140`	$183	$27	$34	0.8×
Hepatitis B vaccine HCPCS Code: `90744`	$21	$24	$37	0.6×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$23	$24	$39	0.6×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$85	$25	$56	0.4×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$69	$25	$111	0.2×
Blood test, hemoglobin CPT Code: `85018`	$39	$5	$3	unverified

Showing top 25 high-impact procedures of 105 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 36.8%

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

CMS CCN: 500037

CPT 27130

Select Procedure to Audit:

Fair BaseRate™ $13,413

Medicare Rate $13,117

Self-Pay Cash $4,544

Insurer Median $4,544

1. Amount on Your Bill or Quote ($) Pre-filled with Astria Toppenish 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: $2,573 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $2,573

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.8% of gross = $2,573).

Step 2 · Cash vs. Insurance Arbitrage Save $2,447 Paying Cash

Self-Pay Cash Rate ($4,544) Beats Your Bill

Astria Toppenish Hospital's published 45 CFR § 180 self-pay cash rate is $4,544 (vs. $4,544 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: $13,413 Fair BaseRate

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

Your entered amount is at or below the modeled Fair BaseRate benchmark ($13,413).

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: 814670687

Filing Period: 201709

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 (36.8% 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 Composite71/100

Would Recommend81%

Rated 9 or 10 (HCAHPS)74%

Median ER Wait148 min

Left ER Before Seen3%

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 Astria Toppenish Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2026-05-07·cap_corrective_action
CAP Request
Recorded
2026-02-04·warning_notice
Warning Notice
Recorded
2024-12-30·administrative_or_closure
Closure Notice
Recorded
2024-10-31·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (61 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 Pareto Frontier (Price + Quality)

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

Price Index: 0.69× regional baseline

Quality: 56/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Cigna

-66.7%

Zenith

-56.5%

Humana

+79.5%

Median Household Income$68,015U.S. Census ACS

Local Uninsured Share13.0%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 84/100 · Corroborated CMS CCN 500037 EIN 814670687

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 500037) ↗ Verify IRS Form 990 (EIN 814670687) ↗ CMS HCRIS Cost Reports ↗

Published MRF File814670687_astria-toppenish-hospital_standardcharges.csv

Publication / Vintage4/1/2026 · 36.82 MB

Validated Rate Rows4,186 (CMS v3.0.0)

File Integrity Digestc354a63f161b24ef3989…

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