Doctors Medical Center
DOCTORS MEDICAL CENTER in Modesto, CA charges 17.6x the Medicare reimbursement rate on average, with 99% of analyzed procedures showing significant price variations.
Modesto, CA 95350 · Acute Care Hospitals · CMS Rating: 1/5
About the analyst
Priya Iyengar leads the billing code review team at BillRazor Research. She analyzes NCCI bundling edits, DRG coding, and regional rate variation. Expertise: NCCI bundling, DRG analysis, regional pricing.
No credit card required. Results in 60 seconds.
Billing patterns — for-profit
For-profit hospitals in our dataset demonstrate distinct billing patterns, with 628 facilities showing an average markup of 7.8 times Medicare rates. These hospitals typically maintain higher charge structures across most service categories compared to non-profit and government facilities. Common patterns include substantial charges above benchmark rates for emergency services, surgical procedures, and diagnostic imaging. Patients should be aware that initial bills from for-profit hospitals often reflect chargemaster rates rather than negotiated insurance amounts. The billing structure frequently includes separate charges for facility fees, physician services, and ancillary services that may appear as multiple line items. Before receiving care, patients can request cost estimates and inquire about financial assistance programs, which are federally required at all hospital types. Understanding that insurance negotiations typically result in significantly lower actual payments than initial charges can help patients navigate the billing process more effectively when receiving care at for-profit facilities.
Pricing grade
F
Very high
Avg markup vs Medicare
17.56x
Charge / Medicare rate
Max markup
27.28x
Worst procedure
Procedures analyzed
91
With pricing data
Outlier procedures
98.9%
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 |
|---|---|---|---|---|---|
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $128,220 | $64,110 | — | 27.3x |
| CHEST PAIN | 313 | $152,065 | $76,033 | — | 26.7x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC | 071 | $269,616 | $134,808 | — | 26.2x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $282,148 | $141,074 | — | 24.7x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $173,182 | $86,591 | — | 24.5x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $191,105 | $95,552 | — | 23.3x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | 066 | $140,786 | $70,393 | — | 23.1x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $214,446 | $107,223 | — | 22.6x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $143,473 | $71,736 | — | 22.5x |
| DISORDERS OF THE BILIARY TRACT WITH MCC | 444 | $329,816 | $164,908 | — | 22.4x |
| RED BLOOD CELL DISORDERS WITH MCC | 811 | $306,698 | $153,349 | — | 22.2x |
| PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | 175 | $288,356 | $144,178 | — | 21.8x |
| SYNCOPE AND COLLAPSE | 312 | $161,866 | $80,933 | — | 21.6x |
| OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC | 673 | $673,050 | $336,525 | — | 21.4x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $304,859 | $152,430 | — | 21x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $147,965 | $73,983 | — | 20.9x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC | 070 | $318,301 | $159,151 | — | 20.6x |
| CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC | 074 | $169,535 | $84,768 | — | 20.4x |
| PNEUMOTHORAX WITH CC | 200 | $196,412 | $98,206 | — | 20.3x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $290,882 | $145,441 | — | 20.2x |
| RENAL FAILURE WITH CC | 683 | $157,940 | $78,970 | — | 20.1x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC | 091 | $353,129 | $176,564 | — | 20.1x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $238,452 | $119,226 | — | 20x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $185,835 | $92,917 | — | 20x |
| SEIZURES WITH MCC | 100 | $378,941 | $189,470 | — | 19.9x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $138,159 | $69,080 | — | 19.7x |
| HYPERTENSION WITHOUT MCC | 305 | $130,106 | $65,053 | — | 19.7x |
| POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC | 917 | $296,166 | $148,083 | — | 19.6x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $233,098 | $116,549 | — | 19.6x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $135,410 | $67,705 | — | 19.5x |
| POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC | 863 | $152,183 | $76,091 | — | 19.4x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $174,635 | $87,318 | — | 19.3x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC | 322 | $340,138 | $170,069 | — | 19.2x |
| FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC | 563 | $138,315 | $69,158 | — | 19x |
| RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | 208 | $497,978 | $248,989 | — | 18.9x |
| BRONCHITIS AND ASTHMA WITH CC/MCC | 202 | $152,533 | $76,266 | — | 18.8x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $197,107 | $98,554 | — | 18.7x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $328,035 | $164,017 | — | 18.6x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $347,240 | $173,620 | — | 18.6x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $359,280 | $179,640 | — | 18.6x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC | 393 | $272,885 | $136,443 | — | 18.5x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $311,169 | $155,585 | — | 18x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $149,788 | $74,894 | — | 17.9x |
| CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC | 432 | $360,789 | $180,395 | — | 17.9x |
| SEIZURES WITHOUT MCC | 101 | $144,033 | $72,017 | — | 17.6x |
| CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC | 233 | $1,265,885 | $632,942 | — | 17.6x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $127,740 | $63,870 | — | 17.4x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC | 660 | $203,112 | $101,556 | — | 17.3x |
| CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC | 235 | $1,021,937 | $510,968 | — | 17.2x |
| PERIPHERAL VASCULAR DISORDERS WITH MCC | 299 | $273,626 | $136,813 | — | 17.2x |
Showing 50 of 91 procedures
How DOCTORS MEDICAL CENTER compares to nearby hospitals
Comparison based on average markup ratios from federal hospital pricing data (FY 2024). Chargemaster rates are gross charges — they are not what most insured patients pay. Actual costs depend on your insurance plan, negotiated rates, and coverage terms. This comparison is for informational purposes only and does not constitute medical, financial, or legal advice. Verify costs directly with your provider and insurer.
Got a bill from DOCTORS MEDICAL CENTER?
Upload your bill and our AI compares every line item against these benchmark prices. Free analysis in 60 seconds. You only pay if we find savings.
Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.
FAQ — for-profit hospital billing
How much do for-profit hospitals typically charge compared to Medicare rates?
Why do for-profit hospitals charge more than Medicare rates?
Does insurance typically pay the full hospital charge amount?
What should I know about billing differences between hospital types?
Related pricing data
Got a bill from Doctors Medical Center?
Free guides to help you take action
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