CT imaging
CT abdomen and pelvis with contrast
CPT 74177
$200 - $2,983
from 2 insurers · median $1,591
Blue Cross$2,983
Insurer A*$200
Medicare $356
Typical for a hospital with this service line
HOSPITALGovernment - Hospital District or Authority
SUBLETTE COUNTY HEALTH
Pinedale, WY
615 E HENNICK ST, Pinedale, WY 82941307-367-4133
Not rated by CMS
CMS star rating
8
Beds
106
Inpatient discharges a year
$14.2M
Net patient revenue a year
About this hospital
SUBLETTE COUNTY HEALTH is an 8-bed government - hospital district or authority hospital in Pinedale, WY. Below you'll find publicly disclosed negotiated rates and facility details, including 137 disclosed rate categories.
- CCN
- 530038
- NPI
- 1598577611
- Teaching
- No Medicare-funded residents
- Medicare contractor
- Jurisdiction F, Noridian Healthcare Solutions (03001)
Prices for common services
The 24 services SUBLETTE COUNTY HEALTH most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data, or start a free trial.
Cardiology and vascular testing
Complete echocardiogram with Doppler and color flow
CPT 93306
$2,159 - $2,288
from 2 insurers · median $2,223
Cigna$2,288
Insurer A*$2,159
Medicare $558
Typical for a hospital with this service line
CT imaging
CT head or brain without contrast
CPT 70450
$200 - $1,357
from 2 insurers · median $778
Blue Cross$1,357
Insurer A*$200
Medicare $107
Typical for a hospital with this service line
CT imaging
CT of the abdomen and pelvis, without contrast
CPT 74176
$200 - $2,603
from 2 insurers · median $1,402
Blue Cross$2,603
Insurer A*$200
Medicare $244
Typical for a hospital with this service line
Digestive procedures
Colonoscopy with polyp removal
CPT 45385
$2,664 - $3,197
from 2 insurers · median $2,930
Cigna$3,197
Insurer A*$2,664
Medicare $1,223
Typical for a hospital with this service line
Digestive procedures
Colonoscopy with biopsy
CPT 45380
$2,653 - $3,183
from 2 insurers · median $2,918
Cigna$3,183
Insurer A*$2,653
Medicare $1,223
Typical for a hospital with this service line
CT imaging
CT angiography of chest blood vessels
CPT 71275
$200 - $2,350
from 2 insurers · median $1,275
Blue Cross$2,350
Insurer A*$200
Medicare $179
Typical for a hospital with this service line
Mammography
Screening mammography, bilateral
CPT 77067
$200 - $276
from 2 insurers · median $238
Cigna$200
Insurer A*$276
Medicare $92
Typical for a hospital with this service line
X-ray and bone density
Chest X-ray, two views
CPT 71046
$200 - $281
from 2 insurers · median $240
Cigna$200
Insurer A*$281
Medicare $89
Typical for a hospital with this service line
MRI imaging
MRI brain before and after contrast
CPT 70553
$200 - $3,125
from 2 insurers · median $1,662
Blue Cross$3,125
Insurer A*$200
Medicare $356
Typical for a hospital with this service line
Digestive procedures
Diagnostic colonoscopy
CPT 45378
$2,442 - $2,930
from 2 insurers · median $2,686
Cigna$2,930
Insurer A*$2,442
Medicare $950
Typical for a hospital with this service line
MRI imaging
MRI of the abdomen, before and after contrast
CPT 74183
$200 - $4,412
from 2 insurers · median $2,306
Blue Cross$4,412
Insurer A*$200
Medicare $356
Typical for a hospital with this service line
MRI imaging
MRI of the brain, without contrast
CPT 70551
$200 - $2,285
from 2 insurers · median $1,242
Blue Cross$2,285
Insurer A*$200
Medicare $244
Typical for a hospital with this service line
MRI imaging
MRI lumbar spine without contrast
CPT 72148
$200 - $2,236
from 2 insurers · median $1,218
Blue Cross$2,236
Insurer A*$200
Medicare $244
Typical for a hospital with this service line
Laboratory and pathology
Comprehensive metabolic panel
CPT 80053
$36 - $200
from 2 insurers · median $118
Blue Cross$36
Insurer A*$200
Medicare $11
Typical for a hospital with this service line
Ultrasound
Limited ultrasound of the abdomen
CPT 76705
$200 - $557
from 2 insurers · median $379
Blue Cross$557
Insurer A*$200
Medicare $107
Typical for a hospital with this service line
Lung function and sleep
Attended overnight sleep study
CPT 95810
$3,542 - $4,250
from 2 insurers · median $3,896
Blue Cross$3,542
Insurer A*$4,250
Medicare $877
Typical for a hospital with this service line
Lung function and sleep
Overnight sleep study with positive-airway-pressure titration
CPT 95811
$4,007 - $4,809
from 2 insurers · median $4,408
Blue Cross$4,007
Insurer A*$4,809
Medicare $877
Typical for a hospital with this service line
X-ray and bone density
Foot X-ray, at least three views
CPT 73630
$200 - $354
from 2 insurers · median $277
Cigna$200
Insurer A*$354
Medicare $89
Typical for a hospital with this service line
Cardiology and vascular testing
Ultrasound of veins in one limb or a limited bilateral study
CPT 93971
$200 - $662
from 2 insurers · median $431
Cigna$200
Insurer A*$662
Medicare $107
Typical for a hospital with this service line
Ultrasound
Limited ultrasound of one breast
CPT 76642
$200 - $452
from 2 insurers · median $326
Blue Cross$452
Insurer A*$200
Medicare $89
Typical for a hospital with this service line
X-ray and bone density
Bone-density scan of the spine and hip
CPT 77080
$200 - $419
from 2 insurers · median $310
Cigna$200
Insurer A*$419
Medicare $107
Typical for a hospital with this service line
Ultrasound
Complete pelvic ultrasound
CPT 76856
$200 - $630
from 2 insurers · median $415
Blue Cross$630
Insurer A*$200
Medicare $107
Typical for a hospital with this service line
X-ray and bone density
Shoulder X-ray, at least two views
CPT 73030
$200 - $338
from 2 insurers · median $269
Cigna$200
Insurer A*$338
Medicare $89
Typical for a hospital with this service line
How the insurers pay at SUBLETTE COUNTY HEALTH
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 24 | 482% | 0 | 0 |
| Insurer B* | 24 | 202% | 0 | 0 |
How we chose these services: 0 appear in this hospital's own Medicare claims, 0 are common here based on CMS Medicare volume, and 24 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for SUBLETTE COUNTY HEALTH, or start a free trial.
Insurance Accepted
Acceptance varies by plan and service. Confirm coverage with your insurer or the hospital's billing department.
More about this hospital
Quality
Not rated by CMS
- No Medicare readmissions penalty
Doctors and services
No Medicare-funded residents
- 41 affiliated clinicians
Finances
$14.2M net patient revenue
- Operating margin on patient care -66.4%
- $466,563 unreimbursed and uncompensated care
- -$3.1M net income
Tax IDs and NPIs insurers list
The employer identification numbers (EINs) health plans and networks list for SUBLETTE COUNTY HEALTH in the in-network rate files they publish, with the organization NPIs billed under each.
| Tax ID (EIN) | Plans and networks listing it | Organization NPIs |
|---|---|---|
| 86-1595514Sublette County Hospital District | 26Cigna, Allied Benefit Systems, Aspirus Health Plan, Asuris Northwest Health, BCBS and 21 more | 1598577611 Sublette County Hospital District1104410596 Sublette County Hospital District1699369082 Sublette County Hospital Districtand 4 more |
Source: PayerPrice analysis of insurers' Transparency in Coverage in-network files. An EIN can cover several hospitals and clinics in a health system, and insurers sometimes list other organizations' NPIs under it.
Location
615 E HENNICK ST, Pinedale, WY 82941
307-367-4133
Medicare quality penalties and bonuses
How Medicare adjusts SUBLETTE COUNTY HEALTH's inpatient payments for its readmissions, quality and cost results.
No penalty
Readmissions penalty
Hospital Readmissions Reduction Program adjustment for excess readmissions, as estimated in the FY 2027 IPPS final rule.
0.00% on Medicare payments
Value-based purchasing
Hospital Value-Based Purchasing bonus or reduction for quality and cost, as estimated in the FY 2027 IPPS final rule.
Source: CMS IPPS final rule Impact File (FY 2027).
Every CMS quality measure
Each result CMS publishes for SUBLETTE COUNTY HEALTH, beside the US median and the average of WY hospitals. The rank says what share of US hospitals the result is better or worse than; counts and confidence limits are not ranked.
Deaths and complications20 measures
Risk-adjusted 30-day death rates and surgical complications; lower is better.
| Measure | SUBLETTE COUNTY HEALTH | US median | WY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Rate of complications for hip/knee replacement patients2023-04-01 to 2025-03-31 | Not Available | 3.767 | |||
| Hybrid Hospital-Wide All-Cause Risk Standardized Mortality Rate2024-07-01 to 2025-06-30 | Not Available | 4.074 | |||
| Death rate for heart attack patients2022-07-01 to 2025-06-30 | Not Available | 11.45 | |||
| Death rate for CABG surgery patients2022-07-01 to 2025-06-30 | Not Available | 3.7 | |||
| Death rate for COPD patients2022-07-01 to 2025-06-30 | Not Available | 8.873 | |||
| Death rate for heart failure patients2022-07-01 to 2025-06-30 | Not Available | 12.33 | |||
| Death rate for pneumonia patients2022-07-01 to 2025-06-30 | Not Available | 16.4 | |||
| Death rate for stroke patients2023-07-01 to 2025-06-30 | Not Available | 12.43 | |||
| Pressure ulcer rate2022-07-01 to 2024-06-30 | Not Available | 0.777 | |||
| Death rate among surgical inpatients with serious treatable complications2022-07-01 to 2024-06-30 | Not Available | 187 | |||
| Iatrogenic pneumothorax rate2022-07-01 to 2024-06-30 | Not Available | 0.206 | |||
| In-hospital fall-associated fracture rate2022-07-01 to 2024-06-30 | Not Available | 0.275 | |||
| Postoperative hemorrhage or hematoma rate2022-07-01 to 2024-06-30 | Not Available | 2.273 | |||
| Postoperative acute kidney injury requiring dialysis rate2022-07-01 to 2024-06-30 | Not Available | 1.71 | |||
| Postoperative respiratory failure rate2022-07-01 to 2024-06-30 | Not Available | 9.238 | |||
| Perioperative pulmonary embolism or deep vein thrombosis rate2022-07-01 to 2024-06-30 | Not Available | 3.484 | |||
| Postoperative sepsis rate2022-07-01 to 2024-06-30 | Not Available | 5.027 | |||
| Postoperative wound dehiscence rate2022-07-01 to 2024-06-30 | Not Available | 1.715 | |||
| Abdominopelvic accidental puncture or laceration rate2022-07-01 to 2024-06-30 | Not Available | 1.129 | |||
| CMS Medicare PSI 90: Patient safety and adverse events composite2022-07-01 to 2024-06-30 | Not Available | 1.04 |
Readmissions and return visits14 measures
Unplanned returns to a hospital after a stay or an outpatient procedure; lower is better.
| Measure | SUBLETTE COUNTY HEALTH | US median | WY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Hospital return days for heart attack patients2022-07-01 to 2025-06-30 | Not Available | 1.533 | |||
| Hospital return days for heart failure patients2022-07-01 to 2025-06-30 | Not Available | -23.59 | |||
| Hospital return days for pneumonia patients2022-07-01 to 2025-06-30 | Not Available | -0.4773 | |||
| Hybrid Hospital-Wide All-Cause Readmission Measure (HWR)2024-07-01 to 2025-06-30 | Not Available | ||||
| Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)2022-01-01 to 2024-12-31 | Not Available | 13.21 | |||
| Rate of inpatient admissions for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 | Not Available | 10.4 | |||
| Rate of emergency department (ED) visits for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 | Not Available | 5.713 | |||
| Ratio of unplanned hospital visits after hospital outpatient surgery2024-01-01 to 2024-12-31 | Not Available | 1.014 | |||
| Acute Myocardial Infarction (AMI) 30-Day Readmission Rate2023-07-01 to 2025-06-30 | Not Available | 14.3 | |||
| Rate of readmission for CABG2023-07-01 to 2025-06-30 | Not Available | 12.85 | |||
| Rate of readmission for chronic obstructive pulmonary disease (COPD) patients2023-07-01 to 2025-06-30 | Not Available | 19.32 | |||
| Heart failure (HF) 30-Day Readmission Rate2023-07-01 to 2025-06-30 | Not Available | 20.64 | |||
| Rate of readmission after hip/knee replacement2023-07-01 to 2025-06-30 | Not Available | 6.15 | |||
| Pneumonia (PN) 30-Day Readmission Rate2023-07-01 to 2025-06-30 | Not Available | 17.05 |
Infections36 measures
Standardized infection ratios (1 is the US baseline) and the counts behind them; lower is better.
| Measure | SUBLETTE COUNTY HEALTH | US median | WY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Central Line Associated Bloodstream Infection (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.011 | |||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 1.113 | |||
| Central Line Associated Bloodstream Infection: Number of Device Days2024-10-01 to 2025-09-30 | Not Available | 805 | |||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | Not Available | 0.6224 | |||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | Not Available | 0.1176 | |||
| Central Line Associated Bloodstream Infection (ICU + select Wards)2024-10-01 to 2025-09-30 | Not Available | 0.226 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.0805 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.187 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Number of Urinary Catheter Days2024-10-01 to 2025-09-30 | Not Available | 924 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | Not Available | 0.803 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | Not Available | 0.381 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards)2024-10-01 to 2025-09-30 | Not Available | 0.3465 | |||
| SSI - Colon Surgery: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.1907 | |||
| SSI - Colon Surgery: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 3.285 | |||
| SSI - Colon Surgery: Number of Procedures2024-10-01 to 2025-09-30 | Not Available | 30.5 | |||
| SSI - Colon Surgery: Predicted Cases2024-10-01 to 2025-09-30 | Not Available | 0.8166 | |||
| SSI - Colon Surgery: Observed Cases2024-10-01 to 2025-09-30 | Not Available | 0.9167 | |||
| SSI - Colon Surgery2024-10-01 to 2025-09-30 | Not Available | 0.977 | |||
| SSI - Abdominal Hysterectomy: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | ||||
| SSI - Abdominal Hysterectomy: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | ||||
| SSI - Abdominal Hysterectomy: Number of Procedures2024-10-01 to 2025-09-30 | Not Available | 15.5 | |||
| SSI - Abdominal Hysterectomy: Predicted Cases2024-10-01 to 2025-09-30 | Not Available | 0.1219 | |||
| SSI - Abdominal Hysterectomy: Observed Cases2024-10-01 to 2025-09-30 | Not Available | 0.1 | |||
| SSI - Abdominal Hysterectomy2024-10-01 to 2025-09-30 | Not Available | ||||
| MRSA Bacteremia: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | ||||
| MRSA Bacteremia: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 1.862 | |||
| MRSA Bacteremia: Patient Days2024-10-01 to 2025-09-30 | Not Available | 8,401 | |||
| MRSA Bacteremia: Predicted Cases2024-10-01 to 2025-09-30 | Not Available | 0.324 | |||
| MRSA Bacteremia: Observed Cases2024-10-01 to 2025-09-30 | Not Available | 0.1176 | |||
| MRSA Bacteremia2024-10-01 to 2025-09-30 | Not Available | 0 | |||
| Clostridium Difficile (C.Diff): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.1136 | |||
| Clostridium Difficile (C.Diff): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 1.641 | |||
| Clostridium Difficile (C.Diff): Patient Days2024-10-01 to 2025-09-30 | Not Available | 7,163 | |||
| Clostridium Difficile (C.Diff): Predicted Cases2024-10-01 to 2025-09-30 | Not Available | 3.377 | |||
| Clostridium Difficile (C.Diff): Observed Cases2024-10-01 to 2025-09-30 | Not Available | 1.55 | |||
| Clostridium Difficile (C.Diff)2024-10-01 to 2025-09-30 | Not Available | 0.4974 |
Patient survey (HCAHPS)68 measures
How recent inpatients answered each survey question, with CMS's star rating per topic.
| Measure | SUBLETTE COUNTY HEALTH | US median | WY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Room was "always" clean2024-10-01 to 2025-09-30 | Not Available | 75.86 | |||
| Room was "sometimes" or "never" clean2024-10-01 to 2025-09-30 | Not Available | 6.636 | |||
| Room was "usually" clean2024-10-01 to 2025-09-30 | Not Available | 17.5 | |||
| Cleanliness - linear mean score2024-10-01 to 2025-09-30 | Not Applicable | 88.23 | |||
| Cleanliness - star rating2024-10-01 to 2025-09-30 | Not Applicable | 3.769 | |||
| Nurses "always" communicated well2024-10-01 to 2025-09-30 | Not Available | 82.23 | |||
| Nurse communication - linear mean score2024-10-01 to 2025-09-30 | Not Applicable | 92.23 | |||
| Nurses "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 | Not Available | 3.364 | |||
| Nurse communication - star rating2024-10-01 to 2025-09-30 | Not Applicable | 3.846 | |||
| Nurses "usually" communicated well2024-10-01 to 2025-09-30 | Not Available | 14.41 | |||
| Doctors "always" communicated well2024-10-01 to 2025-09-30 | Not Available | 81.41 | |||
| Doctor communication - linear mean score2024-10-01 to 2025-09-30 | Not Applicable | 91.92 | |||
| Doctors "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 | Not Available | 4.182 | |||
| Doctor communication - star rating2024-10-01 to 2025-09-30 | Not Applicable | 3.385 | |||
| Doctors "usually" communicated well2024-10-01 to 2025-09-30 | Not Available | 14.41 | |||
| Staff "always" explained2024-10-01 to 2025-09-30 | Not Available | 66.41 | |||
| Communication about medicines - linear mean score2024-10-01 to 2025-09-30 | Not Applicable | 80.31 | |||
| Staff "sometimes" or "never" explained2024-10-01 to 2025-09-30 | Not Available | 15.05 | |||
| Communication about medicines - star rating2024-10-01 to 2025-09-30 | Not Applicable | 3.231 | |||
| Staff "usually" explained2024-10-01 to 2025-09-30 | Not Available | 18.55 | |||
| Discharge information - linear mean score2024-10-01 to 2025-09-30 | Not Applicable | 88.54 | |||
| No, staff "did not" give patients this information2024-10-01 to 2025-09-30 | Not Available | 11.09 | |||
| Discharge information - star rating2024-10-01 to 2025-09-30 | Not Applicable | 3.923 | |||
| Yes, staff "did" give patients this information2024-10-01 to 2025-09-30 | Not Available | 88.91 | |||
| No, staff "did not" give patients information about help after discharge2024-10-01 to 2025-09-30 | Not Available | 12.47 | |||
| Yes, staff "did" give patients information about help after discharge2024-10-01 to 2025-09-30 | Not Available | 87.53 | |||
| Doctors "always" explained things so they could understand2024-10-01 to 2025-09-30 | Not Available | 75.71 | |||
| Doctors "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 | Not Available | 5.706 | |||
| Doctors "usually" explained things so they could understand2024-10-01 to 2025-09-30 | Not Available | 18.59 | |||
| Doctors "always" listened carefully2024-10-01 to 2025-09-30 | Not Available | 79.88 | |||
| Doctors "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 | Not Available | 4.765 | |||
| Doctors "usually" listened carefully2024-10-01 to 2025-09-30 | Not Available | 15.35 | |||
| Doctors "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 | Not Available | 87.12 | |||
| Doctors "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 | Not Available | 2.706 | |||
| Doctors "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 | Not Available | 10.18 | |||
| Patients who gave a rating of "6" or lower (low)2024-10-01 to 2025-09-30 | Not Available | 6.864 | |||
| Patients who gave a rating of "7" or "8" (medium)2024-10-01 to 2025-09-30 | Not Available | 19.64 | |||
| Patients who gave a rating of "9" or "10" (high)2024-10-01 to 2025-09-30 | Not Available | 73.5 | |||
| Overall hospital rating - linear mean score2024-10-01 to 2025-09-30 | Not Applicable | 88.46 | |||
| Overall hospital rating - star rating2024-10-01 to 2025-09-30 | Not Applicable | 3.538 | |||
| Staff "always" explained new medications2024-10-01 to 2025-09-30 | Not Available | 77.47 | |||
| Staff "sometimes" or "never" explained new medications2024-10-01 to 2025-09-30 | Not Available | 7.824 | |||
| Staff "usually" explained new medications2024-10-01 to 2025-09-30 | Not Available | 14.71 | |||
| Nurses "always" explained things so they could understand2024-10-01 to 2025-09-30 | Not Available | 76.35 | |||
| Nurses "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 | Not Available | 5.118 | |||
| Nurses "usually" explained things so they could understand2024-10-01 to 2025-09-30 | Not Available | 18.53 | |||
| Nurses "always" listened carefully2024-10-01 to 2025-09-30 | Not Available | 78.29 | |||
| Nurses "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 | Not Available | 3.471 | |||
| Nurses "usually" listened carefully2024-10-01 to 2025-09-30 | Not Available | 18.24 | |||
| Nurses "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 | Not Available | 87.88 | |||
| Nurses "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 | Not Available | 2.118 | |||
| Nurses "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 | Not Available | 10 | |||
| "Always" quiet at night2024-10-01 to 2025-09-30 | Not Available | 62.5 | |||
| "Sometimes" or "never" quiet at night2024-10-01 to 2025-09-30 | Not Available | 7.818 | |||
| "Usually" quiet at night2024-10-01 to 2025-09-30 | Not Available | 29.68 | |||
| Quietness - linear mean score2024-10-01 to 2025-09-30 | Not Applicable | 83.92 | |||
| Quietness - star rating2024-10-01 to 2025-09-30 | Not Applicable | 3.846 | |||
| "NO", patients would not recommend the hospital (they probably would not or definitely would not recommend it)2024-10-01 to 2025-09-30 | Not Available | 4.591 | |||
| "YES", patients would definitely recommend the hospital2024-10-01 to 2025-09-30 | Not Available | 71.5 | |||
| Recommend hospital - linear mean score2024-10-01 to 2025-09-30 | Not Applicable | 87.54 | |||
| "YES", patients would probably recommend the hospital2024-10-01 to 2025-09-30 | Not Available | 23.91 | |||
| Recommend hospital - star rating2024-10-01 to 2025-09-30 | Not Applicable | 3.769 | |||
| Staff "always" explained possible side effects2024-10-01 to 2025-09-30 | Not Available | 52.12 | |||
| Staff "sometimes" or "never" explained possible side effects2024-10-01 to 2025-09-30 | Not Available | 25.59 | |||
| Staff "usually" explained possible side effects2024-10-01 to 2025-09-30 | Not Available | 22.29 | |||
| Summary star rating2024-10-01 to 2025-09-30 | Not Applicable | 3.615 | |||
| No, staff "did not" give patients information about possible symptoms2024-10-01 to 2025-09-30 | Not Available | 9.824 | |||
| Yes, staff "did" give patients information about possible symptoms2024-10-01 to 2025-09-30 | Not Available | 90.18 |
Timely and effective care23 measures
How often the hospital gave recommended care, and how fast.
| Measure | SUBLETTE COUNTY HEALTH | US median | WY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Emergency department volume2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Malnutrition Diagnosis Documented2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Malnutrition Risk Screening2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Nutrition Assessment2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Nutritional Care Plan2024-01-01 to 2024-12-31 | Not Available | ||||
| Hospital Harm - Severe Hyperglycemia2024-01-01 to 2024-12-31 | Not Available | 10.67 | |||
| Hospital Harm - Severe Hypoglycemia2024-01-01 to 2024-12-31 | Not Available | 1.545 | |||
| Hospital Harm - Opioid Related Adverse Events2024-01-01 to 2024-12-31 | Not Available | 0.2222 | |||
| Healthcare workers given influenza vaccination2024-10-01 to 2025-03-31 | Not Available | 77.26 | |||
| Average (median) time all patients spent in the emergency department before leaving from the visit, including psychiatric/mental health patients and patients who were transferred to another facility. A lower number of minutes is better2024-10-01 to 2025-09-30 | Not Available | 133 | |||
| Average (median) time patients spent in the emergency department before leaving from the visit, excluding patients transferred to another facility or psychiatric care/mental health patients. A lower number of minutes is better2024-10-01 to 2025-09-30 | Not Available | 126 | |||
| Average (median) time psychiatric/mental health patients spent in the emergency department before leaving from the visit. A lower number of minutes is better2024-10-01 to 2025-09-30 | Not Available | 225 | |||
| Average (median) time patients spent in the emergency department before being transferred to another facility. A lower number of minutes is better2024-10-01 to 2025-09-30 | Not Available | 245 | |||
| Left before being seen2024-01-01 to 2024-12-31 | Not Available | 0.45 | |||
| Head CT results2024-10-01 to 2025-09-30 | Not Available | 67 | |||
| Endoscopy/polyp surveillance: appropriate follow-up interval for normal colonoscopy in average risk patients2024-01-01 to 2024-12-31 | Not Available | 91.38 | |||
| Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery2024-01-01 to 2024-12-31 | Not Available | ||||
| Appropriate care for severe sepsis and septic shock2024-10-01 to 2025-09-30 | Not Available | 60.75 | |||
| Septic Shock 3-Hour Bundle2024-10-01 to 2025-09-30 | Not Available | 73.22 | |||
| Septic Shock 6-Hour Bundle2024-10-01 to 2025-09-30 | Not Available | 82.4 | |||
| Severe Sepsis 3-Hour Bundle2024-10-01 to 2025-09-30 | Not Available | 80.17 | |||
| Severe Sepsis 6-Hour Bundle2024-10-01 to 2025-09-30 | Not Available | 90.82 |
Outpatient imaging2 measures
How often scans were ordered when they may not be needed; lower is better.
| Measure | SUBLETTE COUNTY HEALTH | US median | WY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Abdomen CT Use of Contrast Material2024-07-01 to 2025-06-30 | Not Available | 5.41 | |||
| Breast Cancer Screening Recall Rates2024-07-01 to 2025-06-30 | Not Available | 7.681 |
Medicare spending per patient1 measure
Medicare spending around an inpatient stay compared with the US (1 is the US median).
| Measure | SUBLETTE COUNTY HEALTH | US median | WY average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Medicare hospital spending per patient (Medicare Spending per Beneficiary)2024-01-01 to 2024-12-31 | Not Available | 0.9675 |
Source: CMS Care Compare hospital files, latest release 2026-09-30, with program results for earlier fiscal years from CMS's archived snapshots. US medians and ranks count every hospital CMS reports; state averages are plain means of the state's reporting hospitals, not CMS's patient-weighted state rates.
Size and patient volume
What SUBLETTE COUNTY HEALTH reported to Medicare in its latest cost report, covering Sep 16, 2025 to Feb 25, 2026.
106
Inpatient discharges
Medicare 38%, Medicaid n/a
400
Inpatient days
24% of available bed days used
82
Employees (full-time equivalent)
Source: CMS cost report (HCRIS) (report 842330). Figures cover the reporting period, which is not always 12 months, and are self-reported.
Utilization by payer and unit
Inpatient days and discharges SUBLETTE COUNTY HEALTH reported by payer. Medicare and Medicaid include their managed care plans, shown separately below.
| Medicare | Medicaid | Other | Total | |
|---|---|---|---|---|
| Inpatient days | 180 | 0 | 220 | 400 |
| Discharges | 40 | 0 | 66 | 106 |
| Average length of stay | 4.5 days | 3.3 days | 3.8 days | |
| Average daily census | 1.1 | 0.0 | 1.3 | 2.5 |
Beds and days by unit
| Unit | Beds | Inpatient days | Medicare days | Occupancy |
|---|---|---|---|---|
| Adults & pediatrics | 8 | 400 | 180 | 24% |
Source: CMS cost report (HCRIS, Form 2552-10), report 842330, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheet S-3 Part I.
Where patients come from
ZIP codes with the most Medicare inpatient stays at SUBLETTE COUNTY HEALTH in 2025. Market share is this hospital's part of every hospital's Medicare stays from the ZIP code.
| ZIP code | Stays | Of this hospital's stays | Days | Charges | Market share |
|---|---|---|---|---|---|
| 82941 | 16 | 100% | 69 | $476,133 | 8% |
Source: CMS Hospital Service Area file. Shares are of the 16 stays from ZIP codes CMS publishes; it omits ZIP codes with fewer than 11 stays, so market shares count published stays only.
Doctors and clinicians
41 clinicians who bill Medicare list SUBLETTE COUNTY HEALTH as a hospital affiliation. Showing 24 of them. Book a demo to see the commercial rates insurers publish for them, or start a free trial.
- Physician Assistant 6
- Internal Medicine Physician 5
- Emergency Medicine Physician 4
- Family Medicine Physician 3
- Family Nurse Practitioner 3
- Medical Physician Assistant 3
- Orthopaedic Surgery Physician 3
- Cardiovascular Disease Physician 2
- Urology Physician 2
- Acute Care Nurse Practitioner 1
William Lighthart, M.D.
Adult Reconstructive Orthopaedic Surgery Physician
NPI 1427004647
See commercial rates for William Lighthart, M.D.Geoffrey Skene, DO
Pain Medicine Physician
NPI 1114928223
See commercial rates for Geoffrey Skene, DOMansour Khaddr, M.D.
Cardiovascular Disease Physician
NPI 1124384797
See commercial rates for Mansour Khaddr, M.D.David Khoury, MD
Orthopaedic Surgery Physician
NPI 1760521702
See commercial rates for David Khoury, MDEric Kerley, MD
Hospitalist Physician
NPI 1770533523
See commercial rates for Eric Kerley, MDGlenn Burnett, MD
Internal Medicine Physician
NPI 1467400747
See commercial rates for Glenn Burnett, MDRafael Hastey, M.D.
Internal Medicine Physician
NPI 1871989665
See commercial rates for Rafael Hastey, M.D.Rafael Williams, M.D.
Orthopaedic Surgery Physician
NPI 1225067606
See commercial rates for Rafael Williams, M.D.Andras Eder, MD
Family Medicine Physician
NPI 1851603146
See commercial rates for Andras Eder, MDHeidi Michelsen Jost, MD
Orthopaedic Surgery Physician
NPI 1649272204
See commercial rates for Heidi Michelsen Jost, MDChristine Turner, MD
Internal Medicine Physician
NPI 1194914747
See commercial rates for Christine Turner, MDJonathan Said, PA-C
Medical Physician Assistant
NPI 1730392598
See commercial rates for Jonathan Said, PA-CNoah Chutz
Physician Assistant
NPI 1457879009
See commercial rates for Noah ChutzKelsey Wagner, PA
Physician Assistant
NPI 1538647631
See commercial rates for Kelsey Wagner, PARyan Grove
Medical Physician Assistant
NPI 1821521659
See commercial rates for Ryan GroveRahul Pawar, MD
Nephrology Physician
NPI 1639455090
See commercial rates for Rahul Pawar, MDTed Morgan, M.D.
Urology Physician
NPI 1639160245
See commercial rates for Ted Morgan, M.D.Cody Christensen, DO
Urology Physician
NPI 1962765586
See commercial rates for Cody Christensen, DOMartin Trott, MD
Otolaryngology Physician
NPI 1245339456
See commercial rates for Martin Trott, MDCori Wenz
Medical Physician Assistant
NPI 1609425859
See commercial rates for Cori WenzMelissa Cohen, M.D.
Medical Oncology Physician
NPI 1174763262
See commercial rates for Melissa Cohen, M.D.Devyn Vore, PA
Physician Assistant
NPI 1013403013
See commercial rates for Devyn Vore, PARex Wortham, M.D.
Family Medicine Physician
NPI 1679580492
See commercial rates for Rex Wortham, M.D.Lacey Martin, PA-C
Physician Assistant
NPI 1639887011
See commercial rates for Lacey Martin, PA-C
Source: CMS Doctors and Clinicians facility affiliations, released 2026-10-15, with names and specialties from NPPES. Affiliation means the clinician bills Medicare for care at this hospital; it is not employment.
Income statement
Revenue, expenses and income SUBLETTE COUNTY HEALTH reported to Medicare for Sep 16, 2025 to Feb 25, 2026. Percentages are of net patient revenue.
| Line | Amount | Share |
|---|---|---|
| Gross patient revenue (charges) | $21.7M | 152.4% |
| Inpatient | $1.8M | 12.6% |
| Outpatient | $19.9M | 139.8% |
| Contractual allowances and discounts | -$7.5M | -52.4% |
| Net patient revenue | $14.2M | 100.0% |
| Operating expenses | -$23.7M | -166.4% |
| Operating income from patient care | -$9.4M | -66.4% |
| Other income | $6.3M | 44.3% |
| Contributions and donations | $787,691 | 5.5% |
| Investment income | $540,913 | 3.8% |
| Other | $5M | 35.0% |
| Net income | -$3.1M | -22.1% |
Gross revenue by payer
| Line | Amount | Share |
|---|---|---|
| Traditional Medicare | $2.2M | 13.3% |
| Medicaid (including managed care) | $845,851 | 5.1% |
| Other payers and self-pay | $13.5M | 81.6% |
| Total charges | $16.6M | 100.0% |
Source: CMS cost report (HCRIS, Form 2552-10), report 842330, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Traditional Medicare is the program charges on Worksheets D-3 and D Part V; Medicaid is from Worksheet S-10.
Financial ratios
Computed from SUBLETTE COUNTY HEALTH's latest cost report, which covers 163 days; income and expense figures are scaled to a year.
-66.4%
Operating margin
Operating income from patient care / net patient revenue
-15.3%
Total margin
Net income / net patient revenue plus other income
2.1%
EBITDAR margin
Net income before interest, depreciation and leases (Worksheet A-7), / total revenue
40% of expenses
Personnel costs
Salaries, direct-care contract labor and core wage-related costs / operating expenses
$44.89
Average hourly wage
Adjusted salaries / paid hours (Worksheet S-3 Part II)
-5.7%
Return on assets
Net income for a year / total assets
-6.4%
Return on equity
Net income for a year / fund balance
-0.00
Long-term debt to fund balance
Mortgages, notes and loans / fund balance
2.20
Current ratio
Current assets / current liabilities
2.34
Quick ratio
Cash, temporary investments and net receivables / current liabilities
177 days
Days cash on hand
Cash and temporary investments / daily operating expenses excluding depreciation
131 days
Days in patient receivables
Net patient receivables / daily net patient revenue
113 days
Average payment period
Current liabilities / daily operating expenses excluding depreciation
0.37
Asset turnover
Total revenue for a year / total assets
1.2 years
Average age of plant
Accumulated depreciation / depreciation for a year
Source: CMS cost report (HCRIS, Form 2552-10), report 842330, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Balance sheet
What SUBLETTE COUNTY HEALTH owned and owed at the end of its reporting period (Feb 2026), across all fund types: $124.2M in total assets and a $109.3M fund balance.
Show the balance sheetHide the balance sheet
| Line | Amount | Of total assets |
|---|---|---|
| Cash and temporary investments | $22.9M | 18.4% |
| Patient receivables, net | $11.4M | 9.2% |
| Inventory | $317,184 | 0.3% |
| Total current assets | $32.2M | 25.9% |
| Property and equipment, net of depreciation | $66.5M | 53.5% |
| Investments and other assets | $25.5M | 20.6% |
| Total assets | $124.2M | 100.0% |
| Current liabilities | $14.6M | 11.8% |
| Long-term debt | -$71,681 | -0.1% |
| Total liabilities | $14.9M | 12.0% |
| Fund balance (net assets) | $109.3M | 88.0% |
Source: CMS cost report (HCRIS, Form 2552-10), report 842330, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Charity care and uncompensated care
Care SUBLETTE COUNTY HEALTH provided without full payment, as reported on Worksheet S-10 of its cost report.
$466,563
Medicaid shortfall
Cost of Medicaid patients (charges times the cost-to-charge ratio) minus Medicaid payments; negative means a surplus
$466,563
Total unreimbursed and uncompensated care
2.0% of operating expenses
Medicaid, CHIP and indigent care shortfalls plus charity care and the cost of bad debt (Worksheet S-10 line 31)
Source: CMS cost report (HCRIS, Form 2552-10), report 842330, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Departments
Each cost center SUBLETTE COUNTY HEALTH reports, largest first. Total cost includes its share of overhead; the cost-to-charge ratio is total cost / charges.
Show all 17 departmentsHide all 17 departments
Ancillary and outpatient departments
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Emergency | $527,585 | $4.2M | $3.6M | 1.14 | 5,667 |
| Ambulance services | $1.1M | $3.5M | $891,376 | 3.94 | 17,000 |
| Laboratory | $441,925 | $2.1M | $3.7M | 0.56 | 1,414 |
| Radiology-diagnostic | $392,590 | $1.4M | $6.5M | 0.22 | 4,182 |
| Drugs charged to patients | $900,665 | $413,243 | 2.18 | 790 | |
| Observation beds (non-distinct part | $167,950 | $79,127 | 2.12 |
Inpatient units
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Adults & pediatrics | $1M | $1.8M | $1.4M | 1.36 | 7,337 |
Overhead (general service) departments
| Department | Salaries | Direct cost | Paid hours | Average hourly wage | Square feet |
|---|---|---|---|---|---|
| Administrative & general | $1.5M | $4.6M | 35,028 | $42.51 | 13,320 |
| Cap rel costs-bldg & fixt | $3.7M | 94,895 | |||
| Dietary | $486,015 | $924,729 | 15,232 | $31.91 | 3,199 |
| Maintenance & repairs | $171,342 | $703,693 | 3,410 | $50.24 | 3,263 |
| Housekeeping | $328,507 | $518,725 | 13,930 | $23.58 | 1,110 |
| Employee benefits department | $204,304 | $365,488 | 3,874 | $52.74 | 245 |
| Nursing administration | $222,445 | 240 | $150.00 | ||
| Laundry & linen service | $122,936 | $138,502 | 2,992 | $41.09 | |
| Cap rel costs-mvble equip | $126,748 | ||||
| Medical records & library | $71,898 | $105,791 | 1,869 | $38.47 |
Source: CMS cost report (HCRIS, Form 2552-10), report 842330, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheets A, B-1, C Part I and S-3 Part II.
Medicare payment profile
The factors Medicare uses to set what it pays SUBLETTE COUNTY HEALTH for an inpatient stay.
1.07
Case mix index
Higher than 3% of hospitals paid under Medicare IPPS
Average Medicare DRG weight of its inpatient cases (FY 2027); higher means more complex, costlier care.
No Medicare-funded residents
Teaching status
Medicare-funded interns and residents per bed (FY 2027).
0.0%
Low-income patient share
Disproportionate share percentage: Medicaid and SSI patient days CMS uses for safety-net payments (FY 2027).
4
Medicare inpatient stays
Medicare claims CMS based FY 2027 payment rates on.
Rural
Location type
Geographic area CMS assigns before any wage index reclassification (FY 2027).
Source: CMS IPPS final rule Impact File (FY 2027).
Frequently asked questions
About SUBLETTE COUNTY HEALTH's rates and hospital price transparency.
How much does an MRI cost at SUBLETTE COUNTY HEALTH?
For MRI brain before and after contrast (CPT 70553), published negotiated rates at SUBLETTE COUNTY HEALTH range from $200 to $3,125 across 2 insurers. Blue Cross Blue Shield's rate is $3,125. What a patient pays depends on their plan's deductible, coinsurance and network status.
How much does a CT scan cost at SUBLETTE COUNTY HEALTH?
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at SUBLETTE COUNTY HEALTH range from $200 to $2,983 across 2 insurers. Blue Cross Blue Shield's rate is $2,983. What a patient pays depends on their plan's deductible, coinsurance and network status.
How much does a colonoscopy cost at SUBLETTE COUNTY HEALTH?
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at SUBLETTE COUNTY HEALTH range from $2,664 to $3,197 across 2 insurers. Cigna's rate is $3,197. What a patient pays depends on their plan's deductible, coinsurance and network status.
How much does a mammogram cost at SUBLETTE COUNTY HEALTH?
For Screening mammography, bilateral (CPT 77067), published negotiated rates at SUBLETTE COUNTY HEALTH range from $200 to $276 across 2 insurers. Cigna's rate is $200. What a patient pays depends on their plan's deductible, coinsurance and network status.
Is SUBLETTE COUNTY HEALTH a teaching hospital?
CMS reports no Medicare-funded interns or residents at SUBLETTE COUNTY HEALTH for fiscal year 2027.
Does Medicare penalize SUBLETTE COUNTY HEALTH for readmissions?
No. SUBLETTE COUNTY HEALTH has no Hospital Readmissions Reduction Program penalty in fiscal year 2027.
What is SUBLETTE COUNTY HEALTH's case mix index?
SUBLETTE COUNTY HEALTH's Medicare case mix index is 1.07 for fiscal year 2027, higher than 3% of hospitals paid under the inpatient prospective payment system.
How many patients does SUBLETTE COUNTY HEALTH admit?
SUBLETTE COUNTY HEALTH reported 106 inpatient discharges and 400 inpatient days from Sep 16, 2025 to Feb 25, 2026.
How many employees does SUBLETTE COUNTY HEALTH have?
SUBLETTE COUNTY HEALTH reported 82 full-time-equivalent employees on payroll from Sep 16, 2025 to Feb 25, 2026.
How much revenue does SUBLETTE COUNTY HEALTH make?
SUBLETTE COUNTY HEALTH reported $14.2M in net patient revenue on $21.7M of gross charges for Sep 16, 2025 to Feb 25, 2026, an operating margin of -66.4%, and net income of -$3.1M.
How much charity and uncompensated care does SUBLETTE COUNTY HEALTH provide?
SUBLETTE COUNTY HEALTH reported $466,563 of unreimbursed and uncompensated care for Sep 16, 2025 to Feb 25, 2026.
What is SUBLETTE COUNTY HEALTH's tax ID (EIN)?
Insurers' price transparency files list SUBLETTE COUNTY HEALTH under employer identification number 86-1595514 (Sublette County Hospital District). 26 health plans and networks list 86-1595514 for it.
How many doctors are affiliated with SUBLETTE COUNTY HEALTH?
41 clinicians who bill Medicare list SUBLETTE COUNTY HEALTH as a hospital affiliation in CMS's Doctors and Clinicians data. The largest groups are physician assistant (6), internal medicine physician (5), emergency medicine physician (4).
Where do SUBLETTE COUNTY HEALTH's patients come from?
In CMS's 2025 Hospital Service Area file, the most Medicare inpatient stays at SUBLETTE COUNTY HEALTH came from ZIP codes 82941 (16).
How many beds does SUBLETTE COUNTY HEALTH have?
SUBLETTE COUNTY HEALTH has 8 beds, including its psychiatric, rehabilitation and other subprovider units, in its latest Medicare cost report. Facility type: HOSPITAL.
Where is SUBLETTE COUNTY HEALTH and what is its phone number?
SUBLETTE COUNTY HEALTH is located at 615 E HENNICK ST, Pinedale, WY 82941. Its main phone number is 307-367-4133.
What is SUBLETTE COUNTY HEALTH's CCN (Medicare provider number)?
SUBLETTE COUNTY HEALTH's CMS Certification Number (CCN), also called its Medicare provider number, is 530038.
What is SUBLETTE COUNTY HEALTH's NPI number?
The National Provider Identifier (NPI) on file for SUBLETTE COUNTY HEALTH is 1598577611.
What price transparency data is available for SUBLETTE COUNTY HEALTH?
137 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
What is a hospital price transparency MRF?
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
What is a chargemaster review?
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
For hospital finance and compliance teams
Running price transparency at a hospital like this one?
The data on this page comes from the files hospitals and payers publish. We help hospitals publish theirs correctly, and take a fresh look at their chargemaster.
Publish a CMS-compliant machine-readable file
We turn your chargemaster and payer contracts into the CMS template file, then keep it current as rates change.
CMS v3 example: standard_charge_information[0]
{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}- CMS template layout, in JSON or CSV
- Gross, discounted cash, payer-specific and de-identified min / max charges
- cms-hpt.txt file and homepage footer link
- Refreshed when your contracts change
Get your chargemaster right for billing and payer contracts
Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers
CodingPricingPayer contractsCompliance
- CPT, HCPCS, revenue code and modifier errors flagged line by line
- Missing, duplicate and outdated charge lines identified
- Charges set below payer allowables caught before lesser-of clauses cut payment
- Revenue impact of charge changes modeled across percent-of-charge and stop-loss terms
- Your negotiated rates benchmarked against peer hospitals for the same payers