Northern Navajo Medical Center
Northern Navajo Medical Center in Shiprock, NM charges 1.8x the Medicare reimbursement rate across analyzed procedures, reflecting pricing typical for federal government-owned hospitals.
Shiprock, NM 87420 · Acute Care Hospitals
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.
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Billing patterns — government-federal
Federal Government Hospitals (VA/DoD) in our dataset show distinct billing patterns compared to other ownership types. These 14 facilities demonstrate an average markup of 4.1x Medicare rates, which falls within the mid-range compared to other hospital categories. VA and DoD hospitals typically operate under federal pricing structures that may differ significantly from private healthcare facilities. Patients should be aware that while these hospitals serve specific populations (veterans and military families), their charge patterns can still vary considerably from Medicare benchmarks. The billing structure at federal facilities often reflects government healthcare pricing models, which may include different cost accounting methods and reimbursement frameworks. Veterans eligible for VA care and military beneficiaries using DoD facilities should verify their coverage status and understand any potential differences between posted charges and their actual financial responsibility under federal healthcare programs.
Pricing grade
A
Excellent
Avg markup vs Medicare
1.83x
Charge / Medicare rate
Max markup
3.42x
Worst procedure
Procedures analyzed
10
With pricing data
Outlier procedures
0%
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 |
|---|---|---|---|---|---|
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $29,805 | $14,902 | — | 3.4x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $21,656 | $10,828 | — | 2.5x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $35,789 | $17,894 | — | 2.5x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $21,028 | $10,514 | — | 1.9x |
| SIGNS AND SYMPTOMS WITHOUT MCC | 948 | $15,381 | $7,691 | — | 1.8x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $14,861 | $7,431 | — | 1.7x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $26,502 | $13,251 | — | 1.3x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $22,234 | $11,117 | — | 1.1x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $12,143 | $6,071 | — | 1.1x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $14,387 | $7,193 | — | 1.1x |
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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 — government-federal 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