St Luke's Hospital - Carbon Campus
ST LUKE'S HOSPITAL - CARBON CAMPUS in Lehighton, PA charges 12.4x the Medicare reimbursement rate across 31 analyzed procedures, with 13% showing significant price variations.
Lehighton, PA 18235 · Acute Care Hospitals · CMS Rating: 4/5
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.
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Pricing grade
F
Very high
Avg markup vs Medicare
12.43x
Charge / Medicare rate
Max markup
16.44x
Worst procedure
Procedures analyzed
31
With pricing data
Outlier procedures
12.9%
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 |
|---|---|---|---|---|---|
| PULMONARY EMBOLISM WITHOUT MCC | 176 | $67,095 | $33,548 | — | 16.4x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $56,018 | $28,009 | — | 15.8x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $71,563 | $35,782 | — | 15.4x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $51,666 | $25,833 | — | 15.2x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $53,051 | $26,526 | — | 14.6x |
| CELLULITIS WITHOUT MCC | 603 | $73,754 | $36,877 | — | 14.6x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $94,768 | $47,384 | — | 14.5x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $68,133 | $34,066 | — | 14.4x |
| DIABETES WITH CC | 638 | $50,509 | $25,254 | — | 14.3x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $63,300 | $31,650 | — | 13.8x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $72,478 | $36,239 | — | 13.6x |
| RENAL FAILURE WITH MCC | 682 | $104,043 | $52,021 | — | 13.1x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $350,117 | $175,059 | — | 12.9x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $70,431 | $35,215 | — | 12.5x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $58,316 | $29,158 | — | 12.4x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $63,011 | $31,506 | — | 12.3x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $64,045 | $32,023 | — | 12.2x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $42,790 | $21,395 | — | 12.2x |
| RENAL FAILURE WITH CC | 683 | $54,598 | $27,299 | — | 12.1x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $71,840 | $35,920 | — | 12x |
| DIABETES WITH MCC | 637 | $76,715 | $38,358 | — | 11.8x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $121,132 | $60,566 | — | 11.8x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC | 314 | $105,298 | $52,649 | — | 11.1x |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC | 057 | $62,994 | $31,497 | — | 11.1x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $89,414 | $44,707 | — | 10.6x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $101,844 | $50,922 | — | 9.9x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $62,156 | $31,078 | — | 9.7x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $89,545 | $44,773 | — | 9.3x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $57,769 | $28,885 | — | 9.1x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC | 091 | $87,241 | $43,621 | — | 8.9x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $51,745 | $25,872 | — | 7.9x |
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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