Saint Clare's Hospital/ Denville Campus
Saint Clare's Hospital/Denville Campus in Denville, New Jersey charges 5.2x the Medicare reimbursement rate across 74 analyzed procedures at this for-profit facility.
Denville, NJ 07834 · 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 — 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
D
High
Avg markup vs Medicare
5.21x
Charge / Medicare rate
Max markup
11.95x
Worst procedure
Procedures analyzed
74
With pricing data
Outlier procedures
4.1%
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 |
|---|---|---|---|---|---|
| ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WIT | 062 | $172,797 | $86,398 | — | 12x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $203,163 | $101,581 | — | 10.1x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $141,845 | $70,923 | — | 9.2x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | 329 | $358,213 | $179,107 | — | 9.1x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O | 246 | $208,791 | $104,395 | — | 8.7x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $129,156 | $64,578 | — | 7.5x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $115,711 | $57,856 | — | 6.9x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $50,836 | $25,418 | — | 6.7x |
| DIABETES WITH CC | 638 | $44,945 | $22,473 | — | 6.6x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | 394 | $46,001 | $23,001 | — | 6.4x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $24,247 | $12,124 | — | 6.4x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $57,605 | $28,802 | — | 6.3x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $36,209 | $18,104 | — | 6.2x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC | 091 | $83,909 | $41,954 | — | 6.1x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $48,364 | $24,182 | — | 5.9x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | 480 | $137,208 | $68,604 | — | 5.9x |
| POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC | 917 | $67,030 | $33,515 | — | 5.8x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC | 854 | $91,605 | $45,802 | — | 5.8x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $218,109 | $109,055 | — | 5.7x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $32,508 | $16,254 | — | 5.6x |
| CELLULITIS WITHOUT MCC | 603 | $37,192 | $18,596 | — | 5.6x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $31,882 | $15,941 | — | 5.6x |
| RENAL FAILURE WITH CC | 683 | $36,405 | $18,202 | — | 5.5x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | 191 | $39,007 | $19,504 | — | 5.5x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $46,866 | $23,433 | — | 5.5x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $70,608 | $35,304 | — | 5.4x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC | 393 | $68,355 | $34,178 | — | 5.4x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $31,245 | $15,622 | — | 5.4x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $52,148 | $26,074 | — | 5.3x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $31,929 | $15,964 | — | 5.3x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $27,219 | $13,610 | — | 5.2x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $55,654 | $27,827 | — | 5.2x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $80,602 | $40,301 | — | 5.1x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $38,830 | $19,415 | — | 5x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $51,340 | $25,670 | — | 5x |
| GASTROINTESTINAL OBSTRUCTION WITH MCC | 388 | $61,299 | $30,650 | — | 4.9x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $27,576 | $13,788 | — | 4.8x |
| BRONCHITIS AND ASTHMA WITH CC/MCC | 202 | $33,980 | $16,990 | — | 4.8x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC | 071 | $40,229 | $20,115 | — | 4.7x |
| COAGULATION DISORDERS | 813 | $57,680 | $28,840 | — | 4.7x |
| URINARY STONES WITHOUT MCC | 694 | $23,182 | $11,591 | — | 4.7x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $56,821 | $28,410 | — | 4.6x |
| SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | 870 | $259,635 | $129,817 | — | 4.6x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | 092 | $35,561 | $17,781 | — | 4.6x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $32,372 | $16,186 | — | 4.6x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC | 699 | $37,386 | $18,693 | — | 4.6x |
| SEIZURES WITHOUT MCC | 101 | $31,058 | $15,529 | — | 4.6x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $71,644 | $35,822 | — | 4.5x |
| SEIZURES WITH MCC | 100 | $70,766 | $35,383 | — | 4.5x |
| FRACTURES OF HIP AND PELVIS WITHOUT MCC | 536 | $24,429 | $12,215 | — | 4.5x |
Showing 50 of 74 procedures
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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.
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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