Adventist Health Sonora
ADVENTIST HEALTH SONORA in Sonora, CA charges 7.0x the Medicare reimbursement rate on average, with 18% of analyzed procedures showing significantly higher markups.
Sonora, CA 95370 · Acute Care Hospitals · CMS Rating: 3/5
About the analyst
Kevin Nyk analyzes hospital pricing data at BillRazor Research. He specializes in Medicare reimbursement patterns and chargemaster pricing across U.S. hospitals. Expertise: hospital pricing, Medicare rates, chargemaster analysis.
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Billing patterns — nonprofit-religious
Nonprofit religious hospitals, representing 203 facilities in the dataset, demonstrate an average markup of 5.4x Medicare rates, positioning them in the mid-range compared to other ownership types. These institutions typically maintain standardized charge structures across their health system networks, often reflecting their mission-driven approach to healthcare delivery. Patients at nonprofit religious hospitals may encounter charges above the benchmark for routine procedures, though many offer financial assistance programs and charity care policies that can significantly reduce out-of-pocket expenses for qualifying individuals. Common billing patterns include transparent pricing for elective procedures and comprehensive financial counseling services. The potential difference between listed charges and actual patient responsibility can be substantial, particularly for uninsured patients who may qualify for sliding-scale payment options. Patients should inquire about available financial assistance programs during the admissions process, as these hospitals often have more flexible payment arrangements compared to for-profit facilities, reflecting their tax-exempt status and community benefit obligations.
Pricing grade
D
High
Avg markup vs Medicare
7.02x
Charge / Medicare rate
Max markup
9.93x
Worst procedure
Procedures analyzed
40
With pricing data
Outlier procedures
17.5%
Above 90th percentile
Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.
| Procedure | Code | Gross charge | Cash price | Medicare | Markup |
|---|---|---|---|---|---|
| DIABETES WITH CC | 638 | $82,514 | $41,257 | — | 9.9x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $68,441 | $34,221 | — | 9.9x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $62,786 | $31,393 | — | 9.3x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC | 071 | $92,184 | $46,092 | — | 9.1x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC | 282 | $56,660 | $28,330 | — | 8.8x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $73,960 | $36,980 | — | 8.8x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $56,243 | $28,122 | — | 8.2x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $91,520 | $45,760 | — | 7.9x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $90,208 | $45,104 | — | 7.9x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $74,114 | $37,057 | — | 7.8x |
| CELLULITIS WITHOUT MCC | 603 | $62,606 | $31,303 | — | 7.8x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC | 482 | $122,897 | $61,448 | — | 7.7x |
| RENAL FAILURE WITH CC | 683 | $65,088 | $32,544 | — | 7.6x |
| SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | 460 | $283,330 | $141,665 | — | 7.4x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $75,232 | $37,616 | — | 7.4x |
| DIABETES WITH MCC | 637 | $102,503 | $51,252 | — | 7.3x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $65,741 | $32,870 | — | 7.3x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $52,433 | $26,216 | — | 7.3x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $89,991 | $44,996 | — | 7.2x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | 329 | $323,374 | $161,687 | — | 6.9x |
| COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC | 455 | $315,989 | $157,995 | — | 6.9x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $142,903 | $71,452 | — | 6.9x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC | 854 | $138,537 | $69,269 | — | 6.8x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $143,372 | $71,686 | — | 6.7x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $83,342 | $41,671 | — | 6.6x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $62,736 | $31,368 | — | 6.6x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $71,591 | $35,795 | — | 6.3x |
| COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC | 454 | $396,564 | $198,282 | — | 6.3x |
| PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | 175 | $84,196 | $42,098 | — | 6.3x |
| GASTROINTESTINAL OBSTRUCTION WITH MCC | 388 | $84,434 | $42,217 | — | 6x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC | 521 | $175,265 | $87,633 | — | 5.8x |
| POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC | 917 | $87,644 | $43,822 | — | 5.8x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $90,827 | $45,413 | — | 5.8x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $113,754 | $56,877 | — | 5.7x |
| RENAL FAILURE WITH MCC | 682 | $81,644 | $40,822 | — | 5.7x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $106,205 | $53,102 | — | 5.4x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $270,942 | $135,471 | — | 5.3x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $85,062 | $42,531 | — | 5.3x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | 480 | $150,220 | $75,110 | — | 5.1x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $76,150 | $38,075 | — | 4.2x |
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Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.
FAQ — nonprofit-religious hospital billing
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Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.
Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use