Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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SUMMIT PACIFIC MEDICAL CENTER

Elma, WA · CCN 501304 · Rates published

You selected G0121 (HCPCS)

COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK

This hospital’s price: $200 across 10 payers · range $165-$546

Source: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbSPMCELMAWA&type=CDMWithoutLabel&fileType=CSV · observed 2026-08-31

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

2,150 distinct procedures filed
14 distinct payers
40,898 rate rows
2026-08-31 last MRF observed

37,795 of 40,898 rate rows are consumer-grade (92.4%)

3,103 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 2,103
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 568
per-diem day rate — not a per-procedure price 296
percent-of-charges filed in the dollar field — excluded from medians 85
exceeds 10× this hospital's gross charge — excluded from medians 51
↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbSPMCELMAWA&type=CDMWithoutLabel&fileType=CSV
Found on page https://summitpacificmedicalcenter.org/patient-price-information-list/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-10
Content fingerprint 62d10c984ffa616a… · 15,488,366 bytes · first seen 2026-09-21

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
J1459
HCPCS
Injection, Immune Globulin (privigen), Intravenous, Non-lyophilized (e.g., Liqui… 13 $4,889.52 $19,050.08 $5,450.44 nat. median
$968

outlier · 5.6×
J3380
HCPCS
Injection, Vedolizumab, Intravenous, 1 Mg 13 $4,697.32 $18,301.24 $5,236.19 nat. median
$59

outlier · 89.0×
J3101
HCPCS
Injection, Tenecteplase, 1 Mg 13 $1,282.08 $14,253.90 $3,959.42 nat. median
$498

outlier · 8.0×
J7168
HCPCS
Prothrombin Complex Concentrate (human), Kcentra, Per I.u. Of Factor Ix Activity 13 $3,336.09 $13,378.01 $3,802.09 nat. median
$589

outlier · 6.5×
J2357
HCPCS
Injection, Omalizumab, 5 Mg 13 $2,889.28 $11,256.94 $3,220.74 nat. median
$682

outlier · 4.7×
J0717
HCPCS
Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Adm… 13 $2,657.14 $10,352.48 $2,961.96 nat. median
$29

outlier · 102.1×
20600001
CDM
Intensive Care Unit - Intermediate ICU 8 $2,116.82 $3,808.85 $2,956.57 nat. median
$2,117

1.4× median
C8929
HCPCS
Transthoracic Echocardiography With Contrast, Or Without Contrast Followed By Wi… 13 $1,305.60 $8,358.30 $2,862.53 nat. median
$1,169

outlier · 2.4×
12110001
CDM
Room & Board - Semi-private (two Beds) - Medical/surgical/gyn 8 $1,942.51 $3,495.20 $2,713.10 nat. median
$1,814

1.5× median
59618
HCPCS
Cesarean Delivery And Care Before And After Delivery Following Attempted Vaginal… 10 $2,447.07 $3,390.17 $2,693.66 nat. median
$2,932

0.9× median
J2997
HCPCS
Injection, Alteplase Recombinant, 1 Mg 13 $86.43 $19,126.35 $2,622.93 nat. median
$428

outlier · 6.1×
15120
HCPCS
Partial Thickness Self Skin Graft To Face, Scalp, Eyelids, Mouth, Neck, Ears, Ar… 13 $497.19 $9,884.70 $2,537.07 nat. median
$3,620

0.7× median
59610
HCPCS
Vaginal Delivery And Care Before And After Delivery After Previous Cesarean Deli… 10 $2,281.20 $3,160.37 $2,512.99 nat. median
$3,150

0.8× median
12010004
CDM
Room & Board - Semi-private (two Beds) - General Classification 8 $1,749.77 $3,148.40 $2,443.90 nat. median
$1,614

1.5× median
59510
HCPCS
Cesarean Delivery With Care Before And After Delivery 10 $2,406.07 $3,356.53 $2,422.79 nat. median
$3,349

0.7× median
59400
HCPCS
Vaginal Delivery With Care Before And After Delivery 10 $2,179.62 $3,019.65 $2,406.07 nat. median
$2,933

0.8× median
14301
HCPCS
Repair Of Wound By Transferring Skin, 30.1-60.0 Sq Cm 13 $507.28 $9,087.30 $2,332.41 nat. median
$3,686

0.6× median
27640
HCPCS
Partial Removal Of Shin Bone 13 $486.16 $8,728.20 $2,240.24 nat. median
$3,343

0.7× median
25605
HCPCS
Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit… 13 $309.71 $8,713.80 $2,236.54 nat. median
$1,664

1.3× median
71552
HCPCS
MRI Scan Of Chest Before And After Contrast 13 $1,984.29 $7,731.00 $2,211.93 nat. median
$691

outlier · 3.2×
59409
HCPCS
Vaginal Delivery 13 $701.64 $8,549.10 $2,194.27 nat. median
$3,106

0.7× median
15738
HCPCS
Creation Of Muscle Graft To Leg 13 $732.32 $8,452.80 $2,169.55 nat. median
$3,682

0.6× median
15100
HCPCS
Partial Thickness Self Skin Graft To Trunk, Arms, Or Legs, 100.0 Sq Cm Or 1% Bod… 13 $418.50 $8,422.20 $2,161.70 nat. median
$2,243

1.0× median
74174
HCPCS
CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 13 $1,903.90 $7,417.80 $2,122.32 nat. median
$549

outlier · 3.9×
75635
HCPCS
CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 13 $1,865.79 $7,269.30 $2,079.83 nat. median
$355

outlier · 5.9×
14040
HCPCS
Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, Genitals, Han… 13 $451.77 $8,066.70 $2,070.45 nat. median
$2,206

0.9× median
25565
HCPCS
Closed Treatment Of Broken Midpart Of Both Forearm Bones With Manipulation 13 $281.12 $7,976.70 $2,047.35 nat. median
$1,686

1.2× median
25505
HCPCS
Closed Treatment Of Broken Midpart Of Forearm Bone On Thumb Side With Manipulati… 13 $280.74 $7,813.80 $2,005.54 nat. median
$1,619

1.2× median
14041
HCPCS
Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, Genitals, Han… 13 $448.40 $7,601.40 $1,951.03 nat. median
$2,416

0.8× median
74183
HCPCS
MRI Scan Of Abdomen Before And After Contrast 13 $1,733.42 $6,753.60 $1,932.28 nat. median
$611

outlier · 3.2×
72197
HCPCS
MRI Scan Of Pelvis Before And After Contrast 13 $1,731.11 $6,744.60 $1,929.71 nat. median
$606

outlier · 3.2×
74178
HCPCS
CT Scan Of Abdomen And Pelvis Before And After Contrast 13 $1,729.96 $6,740.10 $1,928.42 nat. median
$539

outlier · 3.6×
27768
HCPCS
Closed Treatment Of Back Portion Of Shin Bone At Ankle With Manipulation 13 $273.27 $7,494.30 $1,923.54 nat. median
$1,717

1.1× median
73720
HCPCS
MRI Scan Of Leg Before And After Contrast 13 $1,720.26 $6,702.30 $1,917.60 nat. median
$754

outlier · 2.5×
25635
HCPCS
Closed Treatment Of Other Broken Wrist Bone With Manipulation 13 $260.37 $7,465.50 $1,916.15 nat. median
$1,671

1.1× median
27818
HCPCS
Closed Treatment Of 3 Broken Lower Leg Bones At Ankle With Manipulation 13 $266.35 $7,374.60 $1,892.81 nat. median
$1,691

1.1× median
11012
HCPCS
Removal Of Foreign Material From Skin, Tissue, Muscle, And Bone At Open Broken A… 13 $359.78 $7,319.70 $1,878.72 nat. median
$2,717

0.7× median
27810
HCPCS
Closed Treatment Of 2 Broken Lower Leg Bones At Ankle With Manipulation 13 $259.62 $7,205.40 $1,849.39 nat. median
$1,679

1.1× median
27762
HCPCS
Closed Treatment Of Inside Portion Of Shin Bone At Ankle With Manipulation 13 $295.51 $7,083.00 $1,817.97 nat. median
$1,858

1.0× median
27840
HCPCS
Closed Treatment Of Dislocated Ankle 13 $234.95 $7,029.90 $1,804.34 nat. median
$422

outlier · 4.3×
73723
HCPCS
MRI Scan Of Leg Joint Before And After Contrast 13 $1,610.76 $6,275.70 $1,795.55 nat. median
$756

outlier · 2.4×
73223
HCPCS
MRI Scan Of Arm Joint Before And After Contrast 13 $1,604.76 $6,252.30 $1,788.85 nat. median
$757

outlier · 2.4×
73206
HCPCS
CT Scan Of Blood Vessels Of Arm With Contrast 13 $1,604.76 $6,252.30 $1,788.85 nat. median
$340

outlier · 5.3×
28120
HCPCS
Partial Removal Of Infected Foot Or Heel Bone 13 $293.08 $6,873.30 $1,764.15 nat. median
$3,417

0.5× median
23655
HCPCS
Closed Treatment Of Dislocated Shoulder With Manipulation Under Anesthesia 13 $247.28 $6,822.90 $1,751.21 nat. median
$1,810

1.0× median
37212
HCPCS
Insertion Of Tube Into Vein For Drug Infusion For Blood Clot With Review By Radi… 13 $1,568.95 $6,112.80 $1,748.94 nat. median
$3,662

outlier · 0.5×
J0129
HCPCS
Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administere… 13 $1,545.17 $6,020.14 $1,722.43 nat. median
$122

outlier · 14.1×
74177
HCPCS
CT Scan Of Abdomen And Pelvis With Contrast 13 $1,524.14 $5,938.20 $1,698.99 nat. median
$501

outlier · 3.4×
64633
HCPCS
Destruction Of Upper Or Middle Spinal Facet Joint Nerves Using Imaging Guidance,… 13 $174.58 $6,533.10 $1,676.83 nat. median
$2,156

0.8× median
74175
HCPCS
CT Scan Of Blood Vessels Of Abdomen With Contrast 13 $1,503.35 $5,857.20 $1,675.81 nat. median
$355

outlier · 4.7×

Other procedures at this hospital

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