How many shoppable procedure prices are published for Forks Community Hospital?

Forks Community Hospital in Forks, WA currently has 123 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Forks Community Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Forks Community Hospital's median negotiated commercial rate is 1.1× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Government - Hospital District or Authority 17 Beds · rural Updated: 2026-07-09

Forks Community Hospital

530 Bogachiel Way, Forks, WA 98331 · 123 Priced Procedures

CMS Overall Rating No CMS Rating

Above Fair Market · Negotiate

1.15×vs. Fair Market Price

Typical commercial prices here are +15% above the fair benchmark (1.15×) even after accounting for local nurse/doctor wages and patient complexity.

82/100 · Corroborated

82/100Self-Pay Cash Beats Insurance 38% of the Time

File Completeness85

Price Logic81

Peer Alignment57

Clean Billing87

Real Cash Discount100

Regional Benchmark Tier

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

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Forks Community Hospital prices routine shoppable procedures near 1.0× Medicare (p50 0.99×) while skewing captive emergency, lab, and upper-quartile codes to 1.3× Medicare (p75 1.52×, +54% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#28 of 58 in WA · 46th State Percentile#1,877 of 3,385 in U.S. · 55th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.84× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 38% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (68/100 safety score) with 72% 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)

Even at low-cost facilities (1.15× 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.
Captive ER (1.2×) & laboratory (1.3×) services average 1.30× higher multiples than routine shoppable care (1.0×)
Upper-quartile procedures (Q75 1.52×) jump +54% above the median procedure ratio (Q50 0.99×)
Consolidated metro market (HHI 9,158) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.0× Medicare

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

Back-Door Captive & ER1.30× Divergence

1.3× Medicare

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

Quantile Tail Spread+54% Upper Tail

Q25 0.84× · Q50 0.99× · Q75 1.52×

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

1.0× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.5× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

0.8× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.2× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.3× MedicareGood

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

0.5× MedicareGood

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

38% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 68/100Fair

Procedure Prices at Forks Community Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 123 published procedures.

Sort:

Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$32,340	$32,340	$19,087	1.7×
Total knee replacement CPT Code: `27447`	$15,406	$15,406	$13,523	1.1×
Total hip replacement CPT Code: `27130`	$13,978	$13,978	$13,413	1.0×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$11,316	$11,316	$6,109	1.9×
Vaginal delivery (full package) CPT Code: `59400`	$7,678	$7,678	$2,680	2.9×
C-section delivery (full package) CPT Code: `59510`	$7,678	$7,678	$2,975	2.6×
Inguinal hernia repair CPT Code: `49505`	$7,466	$7,466	$3,629	2.1×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$5,890	$5,890	$3,372	1.7×
MRI, brain (with and without contrast) CPT Code: `70553`	$5,153	$5,153	$511	10.1×
Breast lump removal CPT Code: `19120`	$4,816	$4,816	$3,875	1.2×
Upper endoscopy with biopsy CPT Code: `43239`	$4,497	$4,497	$987	4.6×
Bunion correction surgery CPT Code: `28296`	$4,079	$4,079	$3,446	1.2×
Colonoscopy (diagnostic) CPT Code: `45378`	$3,818	$3,818	$981	3.9×
MRI, brain (no contrast) CPT Code: `70551`	$3,732	$3,732	$343	10.9×
Colonoscopy with biopsy CPT Code: `45380`	$3,720	$3,720	$1,256	3.0×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$3,528	$3,528	$448	7.9×
CT scan, head (with and without contrast) CPT Code: `70470`	$3,318	$3,318	$258	12.9×
MRI, lower back (no contrast) CPT Code: `72148`	$3,322	$3,322	$338	9.8×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$2,934	$2,934	$303	9.7×
MRI, knee or other leg joint CPT Code: `73721`	$2,723	$2,723	$369	7.4×
Injection procedure for pain management HCPCS Code: `G0260`	$2,268	$2,268	$855	2.7×
CT scan, neck (cervical spine) CPT Code: `72125`	$2,104	$2,104	$169	12.4×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,043	$2,043	$583	3.5×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,814	$1,814	$168	10.8×
CT scan, head (with contrast) CPT Code: `70460`	$1,803	$1,803	$242	7.5×
CT scan, pelvis CPT Code: `72192`	$1,686	$1,686	$163	10.3×
CT scan, head (no contrast) CPT Code: `70450`	$1,648	$1,648	$160	10.3×
CT scan, chest (no contrast) CPT Code: `71250`	$1,644	$1,644	$167	9.8×
CT scan, sinuses CPT Code: `70486`	$1,500	$1,500	$166	9.0×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,340	$1,340	$272	4.9×
Ultrasound, pelvis CPT Code: `76856`	$1,172	$1,172	$130	9.0×
Ultrasound, abdomen (complete) CPT Code: `76700`	$1,098	$1,098	$134	8.2×
Diagnostic procedure preparation HCPCS Code: `G0279`	$826	$826	$35	23.6×
Ultrasound, thyroid and neck CPT Code: `76536`	$753	$753	$132	5.7×
X-ray, lower back CPT Code: `72110`	$588	$588	$112	5.3×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$484	$484	$148	3.3×
Ultrasound, abdomen (limited) CPT Code: `76705`	$399	$399	$126	3.2×
Breathing treatment (nebulizer) CPT Code: `94640`	$394	$394	$201	2.0×
X-ray, neck (cervical spine) CPT Code: `72040`	$366	$366	$93	3.9×
X-ray, shoulder CPT Code: `73030`	$352	$352	$92	3.8×
X-ray, hip CPT Code: `73502`	$352	$352	$93	3.8×
X-ray, pelvis CPT Code: `72170`	$365	$365	$110	3.3×
Blood transfusion CPT Code: `36430`	$372	$372	$498	0.7×
X-ray, chest (two views) CPT Code: `71046`	$345	$345	$93	3.7×
Screening mammogram (both breasts) CPT Code: `77067`	$358	$358	$123	2.9×
Behavioral health residential care HCPCS Code: `H0011`	$291	$364	$364	1.0×
X-ray, hand CPT Code: `73130`	$325	$325	$93	3.5×
X-ray, ankle CPT Code: `73610`	$325	$325	$93	3.5×
X-ray, foot CPT Code: `73630`	$316	$316	$92	3.4×
X-ray, chest (single view) CPT Code: `71045`	$300	$300	$92	3.3×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$265	$265	$64	4.1×
Physical therapy (manual therapy) CPT Code: `97140`	$198	$198	$34	5.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$179	$179	$35	5.1×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$179	$179	$38	4.7×
Occupational therapy (self-care training) CPT Code: `97535`	$175	$175	$38	4.6×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$179	$179	$40	4.5×
Behavioral health day treatment HCPCS Code: `H0010`	$157	$196	$343	0.6×
Physical therapy (functional capacity test) CPT Code: `97750`	$166	$166	$38	4.4×
Mental health services (assessment) HCPCS Code: `H0031`	$202	$191	$140	1.4×
Physical therapy (gait training) CPT Code: `97116`	$140	$140	$33	4.2×
Orthotic fitting and training CPT Code: `97760`	$160	$160	$51	3.1×
Hospital observation (per hour) HCPCS Code: `G0378`	$137	$137	$86	1.6×
Behavioral health assessment HCPCS Code: `H0001`	$171	$162	$157	1.0×
Psychotherapy session (60 minutes) CPT Code: `90837`	$206	$155	$181	0.9×
Psychiatric evaluation (first visit) CPT Code: `90791`	$238	$156	$185	0.8×
Prosthetic fitting and training CPT Code: `97761`	$127	$127	$45	2.8×
Office visit, established patient (30-39 min) CPT Code: `99214`	$320	$99	$123	0.8×
Family therapy session CPT Code: `90847`	$142	$120	$173	0.7×
New patient office visit (30-44 min) CPT Code: `99203`	$223	$83	$110	0.8×
Psychotherapy session (45 minutes) CPT Code: `90834`	$161	$104	$166	0.6×
Typhoid vaccine HCPCS Code: `90675`	$626	$626	$347	1.8×
Culture, blood CPT Code: `87040`	$254	$254	$11	unverified
Blood test, comprehensive metabolic panel CPT Code: `80053`	$212	$212	$11	19.3×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$214	$214	$14	15.3×
Pneumococcal vaccine HCPCS Code: `90732`	$175	$218	$140	1.6×
Blood test, lipase CPT Code: `83690`	$166	$166	$7	23.7×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$168	$168	$203	0.8×
Drug screening test HCPCS Code: `G0480`	$171	$171	$116	unverified
Colorectal cancer screening HCPCS Code: `G0010`	$83	$104	$49	2.1×
Flu vaccine injection HCPCS Code: `G0008`	$78	$98	$48	2.0×
Pneumonia vaccine injection HCPCS Code: `G0009`	$66	$82	$49	1.7×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$75	$75	$56	1.3×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$88	$88	$111	0.8×
Blood test, vitamin D CPT Code: `82306`	$162	$60	$31	1.9×
Office visit, established patient (20-29 min) CPT Code: `99213`	$254	$67	$87	0.8×
Behavioral health living support HCPCS Code: `H2019`	$29	$36	$34	1.1×
Review of medical records for care CPT Code: `90889`	$42	$52	$114	0.5×
Neurobehavioral status check CPT Code: `96116`	$65	$65	$231	0.3×
Flu vaccine (high dose) HCPCS Code: `90656`	$51	$64	$25	unverified
Blood test, basic metabolic panel CPT Code: `80048`	$192	$20	$9	2.2×
Culture, bacterial CPT Code: `87070`	$156	$17	$9	1.9×
Blood test, liver function panel CPT Code: `80076`	$156	$16	$9	1.8×
Blood test, thyroid (TSH) CPT Code: `84443`	$154	$32	$18	1.8×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$140	$34	$20	1.7×
Behavioral health outpatient services HCPCS Code: `H2015`	$17	$19	$16	1.2×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$37	$37	$39	0.9×
Blood test, clotting time (PTT) CPT Code: `85730`	$136	$10	$6	1.7×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$126	$15	$10	1.5×
Blood test, complete blood count (CBC) CPT Code: `85025`	$126	$12	$8	1.5×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$93	$4	$3	1.3×
Blood test, vitamin B12 CPT Code: `82607`	$105	$20	$16	1.3×
Hepatitis B vaccine HCPCS Code: `90744`	$29	$36	$37	1.0×
Extended office visit (prolonged) HCPCS Code: `G2212`	$69	$32	$33	1.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$104	$6	$5	1.2×
Blood test, amylase CPT Code: `82150`	$103	$8	$7	1.1×
Blood test, calcium CPT Code: `82310`	$74	$5	$5	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$74	$5	$5	1.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	$80	$14	$14	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$84	$4	$4	1.0×
Blood test, magnesium CPT Code: `83735`	$89	$7	$7	1.0×
Blood test, potassium CPT Code: `84132`	$81	$5	$5	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$77	$4	$4	1.0×
Community mental health services HCPCS Code: `H0038`	$20	$15	$16	0.9×
Hepatitis C antibody test CPT Code: `86803`	$80	$14	$15	0.9×
Blood test, PSA (prostate screen) CPT Code: `84153`	$71	$16	$19	0.8×
Blood test, sodium CPT Code: `84295`	$74	$4	$5	0.8×
Group therapy session CPT Code: `90853`	$40	$28	$100	0.3×
Blood test, hemoglobin CPT Code: `85018`	$56	$2	$3	0.7×
Blood antibody screen CPT Code: `86850`	$90	$11	$46	0.2×
Psychological testing evaluation CPT Code: `96136`	$24	$25	$128	0.2×
Behavioral health day program HCPCS Code: `H2012`	$19	$17	$100	0.2×
Psychological testing by technician CPT Code: `96138`	$20	$20	$395	0.1×
Residential mental health treatment HCPCS Code: `H2036`	$11	$11	$406	0.0×

Showing top 25 high-impact procedures of 123 total

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

Audit a Bill or Quote at Forks Community Hospital (Zero PHI Required)

CMS CCN: 501325

CPT 871

Select Procedure to Audit:

Fair BaseRate™ $19,087

Medicare Rate $14,117

Self-Pay Cash $32,340

Insurer Median $32,340

1. Amount on Your Bill or Quote ($) Pre-filled with Forks Community 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 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 Save $8,084 Paying Cash

Self-Pay Cash Rate ($32,340) Beats Your Bill

Forks Community Hospital's published 45 CFR § 180 self-pay cash rate is $32,340 (vs. $32,340 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$21,337 Above Fair BaseRate

Negotiate Toward $19,087 Fair BaseRate ($14,117 Medicare)

Your bill ($40,424) is $21,337 above the denoised Fair BaseRate ($19,087) and 2.9× the $14,117 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)

Public IRS & CMS ownership records classify Forks Community 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.

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 Composite68/100

Median ER Wait140 min

Left ER Before Seen1%

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 Forks Community Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2024-06-13·administrative_or_closure
Closure Notice
Recorded
2024-03-08·warning_notice
Warning Notice
Recorded
2023-04-26·administrative_or_closure
Closure Notice
Recorded
2023-01-11·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

Regional Quality & Price Benchmark

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

Price Index: 1.13× regional baseline

Quality: 56/100 CMS composite

Median Household Income$67,999U.S. Census ACS

Local Uninsured Share6.5%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 82/100 · Corroborated CMS CCN 501325

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 501325) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileReports.aspx

Publication / Vintage2026-07-09 · 31.57 MB

Validated Rate Rows4,170 (CMS v3.0.0)

File Integrity Digest201c7f69ca89b7736eb0…

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