CT imaging
CT abdomen and pelvis with contrast
CPT 74177
$619 - $644
from 2 insurers · median $632
Blue Cross$619
Insurer A*$644
Medicare $356Nearby hospitals $1,52359% below nearby hospitals
Typical for a hospital with this service line
Sunland Medical Foundation
Sachse, TX
Sachse, TX
32
Beds
183
Inpatient discharges a year
$10.6M
Net patient revenue a year
21
In-network payers
About this hospital
Sunland Medical Foundation is a 32-bed hospital in Sachse, TX. Below you'll find publicly disclosed negotiated rates and facility details, including 21 in-network payers and 288 disclosed rate categories.
- CCN
- 670319
- NPI
- 1790459162
- Teaching
- No Medicare-funded residents
- Medicare contractor
- Jurisdiction H, Novitas Solutions (04011)
Prices for common services
The 24 services Sunland Medical Foundation 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.
Gynecology
Laparoscopic hysterectomy with tube or ovary removal, uterus up to 250 g
CPT 58571
$5,100 - $15,894
from 3 insurers · median $13,798
UnitedHealthcare$5,100
Insurer A*$13,798
Insurer B*$15,894
Medicare $10,860Nearby hospitals $13,377In line with nearby hospitals
Typical for a hospital with this service line
Digestive procedures
Colonoscopy with polyp removal
CPT 45385
$820 - $2,008
from 3 insurers · median $1,894
Aetna$1,894
Insurer A*$820
Insurer B*$2,008
Medicare $1,223Nearby hospitals $2,87334% below nearby hospitals
Typical for a hospital with this service line
Digestive procedures
Upper GI endoscopy with biopsy
CPT 43239
$830 - $1,572
from 3 insurers · median $1,444
Aetna$1,444
Insurer A*$830
Insurer B*$1,572
Medicare $927Nearby hospitals $2,87350% below nearby hospitals
Typical for a hospital with this service line
Digestive procedures
Colonoscopy with biopsy
CPT 45380
$820 - $1,894
from 3 insurers · median $1,647
Aetna$1,894
Insurer A*$820
Insurer B*$1,647
Medicare $1,223Nearby hospitals $2,87343% below nearby hospitals
Typical for a hospital with this service line
Medicine & Surgery
Laparoscopic cholecystectomy
CPT 47562
$5,100 - $9,116
from 3 insurers · median $6,187
Aetna$9,116
Insurer A*$5,100
Insurer B*$6,187
Medicare $6,176Nearby hospitals $10,01838% below nearby hospitals
Typical for a hospital with this service line
Cardiology and vascular testing
Complete echocardiogram with Doppler and color flow
CPT 93306
$163 - $880
from 2 insurers · median $521
Blue Cross$163
Insurer A*$880
Medicare $558Nearby hospitals $78133% below nearby hospitals
Typical for a hospital with this service line
Medicine & Surgery
Cataract removal with lens insertion
CPT 66984
$1,000 - $3,842
from 3 insurers · median $3,777
Aetna$3,777
Insurer A*$1,000
Insurer B*$3,842
Medicare $2,358Nearby hospitals $4,58018% below nearby hospitals
Typical for a hospital with this service line
Medicine & Surgery
Tonsillectomy and adenoidectomy, patient under age 12
CPT 42820
$9,339 - $9,701
from 2 insurers · median $9,520
Aetna$9,339
Insurer A*$9,701
Medicare $6,048Nearby hospitals $7,68224% above nearby hospitals
Typical for a hospital with this service line
CT imaging
CT head or brain without contrast
CPT 70450
$182 - $281
from 3 insurers · median $187
Blue Cross$182
Insurer A*$187
Insurer B*$281
Medicare $107Nearby hospitals $46059% below nearby hospitals
Typical for a hospital with this service line
X-ray and bone density
Chest X-ray, two views
CPT 71046
$102 - $152
from 2 insurers · median $127
Aetna$152
Insurer A*$102
Medicare $89Nearby hospitals $23346% below nearby hospitals
Typical for a hospital with this service line
Digestive procedures
Diagnostic colonoscopy
CPT 45378
$820 - $1,454
from 3 insurers · median $1,375
Aetna$1,454
Insurer A*$820
Insurer B*$1,375
Medicare $950Nearby hospitals $2,87352% below nearby hospitals
Typical for a hospital with this service line
MRI imaging
MRI brain before and after contrast
CPT 70553
$644 - $792
from 3 insurers · median $687
UnitedHealthcare$792
Insurer A*$644
Insurer B*$687
Medicare $356Nearby hospitals $1,56756% below nearby hospitals
Typical for a hospital with this service line
Gynecology
Hysteroscopy with sampling of the uterine lining
CPT 58558
$2,150 - $4,945
from 3 insurers · median $4,746
UnitedHealthcare$2,150
Insurer A*$4,746
Insurer B*$4,945
Medicare $3,307Nearby hospitals $5,73417% below nearby hospitals
Typical for a hospital with this service line
Medicine & Surgery
Laparoscopic radical prostatectomy
CPT 55866
$7,160 - $16,826
from 3 insurers · median $15,894
Aetna$15,894
Insurer A*$7,160
Insurer B*$16,826
Medicare $10,860Nearby hospitals $16,241In line with nearby hospitals
Typical for a hospital with this service line
Gynecology
Laparoscopic removal of an ovary or fallopian tube
CPT 58661
$3,450 - $9,667
from 2 insurers · median $6,559
UnitedHealthcare$3,450
Insurer A*$9,667
Medicare $6,176Nearby hospitals $11,69044% below nearby hospitals
Typical for a hospital with this service line
CT imaging
CT angiography of chest blood vessels
CPT 71275
$315 - $328
from 2 insurers · median $322
Blue Cross$328
Insurer A*$315
Medicare $179Nearby hospitals $1,04069% below nearby hospitals
Typical for a hospital with this service line
CT imaging
CT of the chest, with contrast
CPT 71260
$233 - $468
from 2 insurers · median $350
Blue Cross$233
Insurer A*$468
Medicare $179Nearby hospitals $60842% below nearby hospitals
Typical for a hospital with this service line
Orthopedics and pain
Arthroscopic ACL reconstruction
CPT 29888
$3,485 - $11,964
from 3 insurers · median $11,569
Blue Cross$11,964
Insurer A*$3,485
Insurer B*$11,569
Medicare $6,938Nearby hospitals $11,138In line with nearby hospitals
Typical for a hospital with this service line
Mammography
Screening mammography, bilateral
CPT 77067
$170
negotiated rate
Blue Cross$170
Medicare $92Nearby hospitals $32247% below nearby hospitals
Typical for a hospital with this service line
Gynecology
Laparoscopic removal of pelvic lesions
CPT 58662
$3,450 - $7,927
from 2 insurers · median $5,689
UnitedHealthcare$3,450
Insurer A*$7,927
Medicare $6,176Nearby hospitals $11,64551% below nearby hospitals
Typical for a hospital with this service line
Medicine & Surgery
Arthroscopic knee meniscectomy
CPT 29881
$1,835 - $5,206
from 3 insurers · median $4,927
Aetna$5,206
Insurer A*$1,835
Insurer B*$4,927
Medicare $3,128Nearby hospitals $5,99918% below nearby hospitals
Typical for a hospital with this service line
Ultrasound
Limited ultrasound of the abdomen
CPT 76705
$112 - $202
from 3 insurers · median $187
UnitedHealthcare$112
Insurer A*$187
Insurer B*$202
Medicare $107Nearby hospitals $26530% below nearby hospitals
Typical for a hospital with this service line
Ear, nose and throat
Ear-tube insertion under general anesthesia
CPT 69436
$1,600 - $2,429
from 2 insurers · median $2,014
UnitedHealthcare$1,600
Insurer A*$2,429
Medicare $1,585Nearby hospitals $2,96632% below nearby hospitals
Typical for a hospital with this service line
How the insurers pay at Sunland Medical Foundation
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* | 19 | 156% | 4 | 13 |
| Insurer B* | 24 | 156% | 1 | 21 |
| Insurer C* | 18 | 67% | 0 | 14 |
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 Sunland Medical Foundation, or start a free trial.
Insurance Accepted
Acceptance varies by plan and service. Confirm coverage with your insurer or the hospital's billing department.
Aspirus Health PlanBanner HealthBaylor Scott & White Health PlanCenteneEMI HealthHarvard Pilgrim Health Care (Point32Health)
More about this hospital
Quality
No Medicare readmissions penalty
See quality ratingsDoctors and services
No Medicare-funded residents
See doctors and servicesFinances
$10.6M net patient revenue
- Operating margin on patient care -840.0%
- $4.6M unreimbursed and uncompensated care
- -$33.9M net income
Tax IDs and NPIs insurers list
The employer identification numbers (EINs) health plans and networks list for Sunland Medical Foundation 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 |
|---|---|---|
| 43-1977757Sunland Medical Foundation | 32Aetna, Cigna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), Ambetter, Aspirus Health Plan and 27 more | 1790459162 Sunland Medical Foundation1497304810 Sunland Medical Foundation |
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
Sachse, TX
Medicare quality penalties and bonuses
How Medicare adjusts Sunland Medical Foundation'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 2026 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 2026 IPPS final rule.
Source: CMS IPPS final rule Impact File (FY 2026).
Size and patient volume
What Sunland Medical Foundation reported to Medicare in its latest cost report, covering Jan 1, 2023 to Jan 31, 2024.
183
Inpatient discharges
Medicare 41%, Medicaid n/a
1,047
Inpatient days
8% of available bed days used
122
Employees (full-time equivalent)
Source: CMS cost report (HCRIS) (report 784585). Figures cover the reporting period, which is not always 12 months, and are self-reported.
Utilization by payer and unit
Inpatient days and discharges Sunland Medical Foundation reported by payer. Medicare and Medicaid include their managed care plans, shown separately below.
| Medicare | Medicaid | Other | Total | |
|---|---|---|---|---|
| Inpatient days | 215 | 0 | 832 | 1,047 |
| Discharges | 75 | 0 | 108 | 183 |
| Average length of stay | 2.9 days | 7.7 days | 5.7 days | |
| Average daily census | 0.5 | 0.0 | 2.1 | 2.6 |
37
Medicare Advantage days
10 discharges
58
Medicaid managed care days
18 discharges
753
Observation bed days
Beds and days by unit
| Unit | Beds | Inpatient days | Medicare days | Occupancy |
|---|---|---|---|---|
| Adults & pediatrics | 28 | 954 | 204 | 8% |
| Intensive care unit | 4 | 93 | 11 | 16% |
Source: CMS cost report (HCRIS, Form 2552-10), report 784585, settled without audit. Hospitals report these figures themselves; they are not audited financial statements. Worksheet S-3 Part I.
Income statement
Revenue, expenses and income Sunland Medical Foundation reported to Medicare for Jan 1, 2023 to Jan 31, 2024. Percentages are of net patient revenue.
| Line | Amount | Share |
|---|---|---|
| Gross patient revenue (charges) | $55.7M | 525.6% |
| Inpatient | $13.4M | 126.3% |
| Outpatient | $42.3M | 399.2% |
| Contractual allowances and discounts | -$45.1M | -425.6% |
| Net patient revenue | $10.6M | 100.0% |
| Operating expenses | -$99.5M | -940.0% |
| Operating income from patient care | -$89M | -840.0% |
| Other income | $55M | 519.4% |
| Net income | -$33.9M | -320.6% |
Gross revenue by payer
| Line | Amount | Share |
|---|---|---|
| Traditional Medicare | $6.6M | 11.9% |
| Other payers and self-pay | $49.2M | 88.1% |
| Total charges | $55.9M | 100.0% |
Source: CMS cost report (HCRIS, Form 2552-10), report 784585, settled without audit. 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 Sunland Medical Foundation's latest cost report.
-840.0%
Operating margin
Operating income from patient care / net patient revenue
-51.8%
Total margin
Net income / net patient revenue plus other income
-38.9%
EBITDAR margin
Net income before interest, depreciation and leases (Worksheet A-7), / total revenue
10% of expenses
Personnel costs
Salaries, direct-care contract labor and core wage-related costs / operating expenses
$32.95
Average hourly wage
Adjusted salaries / paid hours (Worksheet S-3 Part II)
-57.3%
Return on assets
Net income for a year / total assets
2.97
Current ratio
Current assets / current liabilities
2.96
Quick ratio
Cash, temporary investments and net receivables / current liabilities
202 days
Days cash on hand
Cash and temporary investments / daily operating expenses excluding depreciation
179 days
Days in patient receivables
Net patient receivables / daily net patient revenue
75 days
Average payment period
Current liabilities / daily operating expenses excluding depreciation
1.11
Asset turnover
Total revenue for a year / total assets
0.0 years
Average age of plant
Accumulated depreciation / depreciation for a year
Source: CMS cost report (HCRIS, Form 2552-10), report 784585, settled without audit. Hospitals report these figures themselves; they are not audited financial statements.
Balance sheet
What Sunland Medical Foundation owned and owed at the end of its reporting period (Jan 2024), across all fund types: $54.6M in total assets and a -$74.6M fund balance.
Show the balance sheetHide the balance sheet
| Line | Amount | Of total assets |
|---|---|---|
| Cash and temporary investments | $49.6M | 90.9% |
| Patient receivables, net | $4.8M | 8.8% |
| Total current assets | $54.6M | 99.9% |
| Property and equipment, net of depreciation | $42,221 | 0.1% |
| Investments and other assets | $1,600 | 0.0% |
| Total assets | $54.6M | 100.0% |
| Current liabilities | $18.4M | 33.6% |
| Long-term debt | $14M | 25.6% |
| Total liabilities | $129.2M | 236.5% |
| Fund balance (net assets) | -$74.6M | -136.5% |
Source: CMS cost report (HCRIS, Form 2552-10), report 784585, settled without audit. Hospitals report these figures themselves; they are not audited financial statements.
Charity care and uncompensated care
Care Sunland Medical Foundation provided without full payment, as reported on Worksheet S-10 of its cost report.
$5.8M
Bad debt
Patient bills written off as uncollectible, at charges
$4.6M
Total unreimbursed and uncompensated care
4.6% 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 784585, settled without audit. Hospitals report these figures themselves; they are not audited financial statements.
Financial trend
Sunland Medical Foundation's full-year cost reports, by fiscal year end. Reports shorter than ten months are left out.
Show 2 yearsHide 2 years
| Fiscal year ending | Dec 2022 | Jan 2024 |
|---|---|---|
| Net patient revenue | $5.5M | $10.6M |
| Operating expenses | $32.7M | $99.5M |
| Operating margin | -499.6% | -840.0% |
| Net income | -$25.6M | -$33.9M |
| Total assets | $68.6M | $54.6M |
| Discharges | 217 | 183 |
| Inpatient days | 664 | 1,047 |
| Medicare Advantage days | 74 | 37 |
| Beds | 32 | 32 |
| Employees (FTE) | 76 | 122 |
Source: CMS cost report (HCRIS, Form 2552-10), report 784585, settled without audit. Hospitals report these figures themselves; they are not audited financial statements.
Departments
Each cost center Sunland Medical Foundation reports, largest first. Total cost includes its share of overhead; the cost-to-charge ratio is total cost / charges.
Show all 26 departmentsHide all 26 departments
Ancillary and outpatient departments
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Emergency | $8.9M | $20.7M | 0.43 | 7,677 | |
| Operating room | $6.4M | $12.9M | 0.49 | 8,657 | |
| Observation beds (non-distinct part | $5.4M | $4.6M | 1.16 | ||
| Radiology-diagnostic | $3.1M | $2.4M | 1.32 | 3,206 | |
| Laboratory | $3M | $3.4M | 0.89 | 1,912 | |
| Drugs charged to patients | $2.6M | $3M | 0.86 | ||
| Impl. dev. charged to patients | $2.4M | $2.8M | 0.84 | ||
| Ct scan | $2.2M | $2.6M | 0.83 | 892 | |
| Respiratory therapy | $1.1M | $189,771 | 5.59 | 383 | |
| Mri | $629,800 | $115,183 | 5.47 | 1,138 | |
| Medical supplies charged to patient | $539,504 | $581,238 | 0.93 |
Inpatient units
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Adults & pediatrics | $12.2M | $2.2M | 5.57 | 13,846 | |
| Intensive care unit | $1.3M | $406,500 | 3.23 | 1,020 |
Overhead (general service) departments
| Department | Salaries | Direct cost | Paid hours | Average hourly wage | Square feet |
|---|---|---|---|---|---|
| Administrative & general | $9.2M | $12.4M | 46,700 | $30.55 | 4,431 |
| Cap rel costs-bldg & fixt | $9.9M | 73,366 | |||
| Cap rel costs-mvble equip | $6M | ||||
| Operation of plant | $1.4M | 4,366 | $37.39 | 16,807 | |
| Employee benefits department | $1.3M | 2,344 | $80.70 | 2,691 | |
| Pharmacy | $1.3M | 1,480 | |||
| Dietary | $623,543 | 2,862 | |||
| Central services & supply | $566,792 | 3,161 | $36.22 | 2,180 | |
| Housekeeping | $396,489 | 1,055 | |||
| Nursing administration | $280,863 | 4,940 | $56.85 | 190 | |
| Medical records & library | $204,727 | 6,596 | $30.88 | 186 | |
| Social service | $94,289 | 2,166 | $43.53 | 397 | |
| Laundry & linen service | $90,021 | 903 |
Source: CMS cost report (HCRIS, Form 2552-10), report 784585, settled without audit. 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 Sunland Medical Foundation for an inpatient stay.
1.33
Case mix index
Higher than 12% of hospitals paid under Medicare IPPS
Average Medicare DRG weight of its inpatient cases (FY 2026); higher means more complex, costlier care.
No Medicare-funded residents
Teaching status
Medicare-funded interns and residents per bed (FY 2026).
6.8%
Low-income patient share
Disproportionate share percentage: Medicaid and SSI patient days CMS uses for safety-net payments (FY 2026).
29
Medicare inpatient stays
Medicare claims CMS based FY 2026 payment rates on.
Urban (metro area)
Location type
Geographic area CMS assigns before any wage index reclassification (FY 2026).
Show FY 2024 to FY 2026Hide FY 2024 to FY 2026
| IPPS fiscal year | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|
| Case mix index | 1.17 | 1.30 | 1.33 |
| Wage index | 0.933 | 0.936 | 0.972 |
| Readmissions adjustment | 0.00% | 0.00% | 0.00% |
| Value-based purchasing adjustment | 0.00% | 0.00% | 0.00% |
| Medicare inpatient stays | 34 | 56 | 29 |
Source: CMS IPPS final rule Impact File (FY 2026).
Frequently asked questions
About Sunland Medical Foundation's rates and hospital price transparency.
How much does an MRI cost at Sunland Medical Foundation?
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Sunland Medical Foundation range from $644 to $792 across 3 insurers. UnitedHealthcare's rate is $792. The median at nearby comparable hospitals is $1,567. What a patient pays depends on their plan's deductible, coinsurance and network status.
How much does a CT scan cost at Sunland Medical Foundation?
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Sunland Medical Foundation range from $619 to $644 across 2 insurers. Blue Cross Blue Shield's rate is $619. The median at nearby comparable hospitals is $1,523. What a patient pays depends on their plan's deductible, coinsurance and network status.
How much does a colonoscopy cost at Sunland Medical Foundation?
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Sunland Medical Foundation range from $820 to $2,008 across 3 insurers. Aetna's rate is $1,894. The median at nearby comparable hospitals is $2,873. What a patient pays depends on their plan's deductible, coinsurance and network status.
How much does a mammogram cost at Sunland Medical Foundation?
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Sunland Medical Foundation range from $170 to $170 across 1 insurers. Blue Cross Blue Shield's rate is $170. The median at nearby comparable hospitals is $322. What a patient pays depends on their plan's deductible, coinsurance and network status.
Is Sunland Medical Foundation a teaching hospital?
CMS reports no Medicare-funded interns or residents at Sunland Medical Foundation for fiscal year 2026.
Does Medicare penalize Sunland Medical Foundation for readmissions?
No. Sunland Medical Foundation has no Hospital Readmissions Reduction Program penalty in fiscal year 2026.
What is Sunland Medical Foundation's case mix index?
Sunland Medical Foundation's Medicare case mix index is 1.33 for fiscal year 2026, higher than 12% of hospitals paid under the inpatient prospective payment system.
How many patients does Sunland Medical Foundation admit?
Sunland Medical Foundation reported 183 inpatient discharges and 1,047 inpatient days from Jan 1, 2023 to Jan 31, 2024.
How many employees does Sunland Medical Foundation have?
Sunland Medical Foundation reported 122 full-time-equivalent employees on payroll from Jan 1, 2023 to Jan 31, 2024.
How much revenue does Sunland Medical Foundation make?
Sunland Medical Foundation reported $10.6M in net patient revenue on $55.7M of gross charges for Jan 1, 2023 to Jan 31, 2024, an operating margin of -840.0%, and net income of -$33.9M.
How much charity and uncompensated care does Sunland Medical Foundation provide?
Sunland Medical Foundation reported $4.6M of unreimbursed and uncompensated care for Jan 1, 2023 to Jan 31, 2024.
What is Sunland Medical Foundation's tax ID (EIN)?
Insurers' price transparency files list Sunland Medical Foundation under employer identification number 43-1977757 (Sunland Medical Foundation). 32 health plans and networks list 43-1977757 for it.
How many beds does Sunland Medical Foundation have?
Sunland Medical Foundation has 32 beds, including its psychiatric, rehabilitation and other subprovider units, in its latest Medicare cost report.
Where is Sunland Medical Foundation and what is its phone number?
Sunland Medical Foundation is located at Sachse, TX.
What is Sunland Medical Foundation's CCN (Medicare provider number)?
Sunland Medical Foundation's CMS Certification Number (CCN), also called its Medicare provider number, is 670319.
What is Sunland Medical Foundation's NPI number?
The National Provider Identifier (NPI) on file for Sunland Medical Foundation is 1790459162.
Which insurance plans are in network at Sunland Medical Foundation?
Sunland Medical Foundation lists 21 in-network payers, including Aetna, Aspirus Health Plan, BCBS, Banner Health, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
What price transparency data is available for Sunland Medical Foundation?
288 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