SSM Health St Mary's Hospital -centralia
SSM Health St. Mary's Hospital - Centralia charges 3.8x the Medicare reimbursement rate across 22 analyzed procedures, reflecting the pricing structure at this nonprofit-religious facility in Centralia, Illinois.
Centralia, IL 62801 · Acute Care Hospitals · CMS Rating: 2/5
About the analyst
Elena Vasquez leads hospital billing pattern analysis at BillRazor Research. She focuses on identifying overcharges, markup outliers, and patient advocacy strategies. Expertise: hospital billing patterns, overcharge analysis, patient advocacy.
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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
C
Average
Avg markup vs Medicare
3.75x
Charge / Medicare rate
Max markup
5.49x
Worst procedure
Procedures analyzed
22
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 |
|---|---|---|---|---|---|
| SYNCOPE AND COLLAPSE | 312 | $25,112 | $12,556 | — | 5.5x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $32,401 | $16,201 | — | 5.1x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $29,807 | $14,904 | — | 4.7x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $24,422 | $12,211 | — | 4.7x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $21,949 | $10,974 | — | 4.6x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $21,807 | $10,903 | — | 4.4x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $21,256 | $10,628 | — | 4.3x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $35,933 | $17,967 | — | 4.2x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | 191 | $21,869 | $10,935 | — | 4x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $35,062 | $17,531 | — | 3.9x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $30,170 | $15,085 | — | 3.9x |
| CELLULITIS WITHOUT MCC | 603 | $19,391 | $9,695 | — | 3.6x |
| RENAL FAILURE WITH CC | 683 | $20,963 | $10,481 | — | 3.5x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $29,222 | $14,611 | — | 3.4x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $25,922 | $12,961 | — | 3.4x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $26,010 | $13,005 | — | 3.3x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $46,222 | $23,111 | — | 3.3x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $32,958 | $16,479 | — | 3x |
| SEIZURES WITHOUT MCC | 101 | $17,122 | $8,561 | — | 3x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $37,206 | $18,603 | — | 2.9x |
| RENAL FAILURE WITH MCC | 682 | $24,774 | $12,387 | — | 2.5x |
| SEIZURES WITH MCC | 100 | $22,996 | $11,498 | — | 1.7x |
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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