St Luke's Warren Hospital
ST LUKE'S WARREN HOSPITAL in Phillipsburg, NJ charges 9.1x the Medicare reimbursement rate on average, with 40% of analyzed procedures showing significant price variations.
Phillipsburg, NJ 08865 · Acute Care Hospitals · CMS Rating: 5/5
About the analyst
Michael Glenn reviews CMS datasets and drug pricing at BillRazor Research. He focuses on NADAC acquisition costs and procedure coding accuracy. Expertise: drug pricing, NADAC data, CPT coding.
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Pricing grade
F
Very high
Avg markup vs Medicare
9.06x
Charge / Medicare rate
Max markup
13.89x
Worst procedure
Procedures analyzed
35
With pricing data
Outlier procedures
40%
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 |
|---|---|---|---|---|---|
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $180,437 | $90,219 | — | 13.9x |
| DYSEQUILIBRIUM | 149 | $73,374 | $36,687 | — | 12.6x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $67,324 | $33,662 | — | 12.1x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $85,634 | $42,817 | — | 11.3x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $190,539 | $95,270 | — | 11.1x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $62,815 | $31,408 | — | 10.7x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $64,990 | $32,495 | — | 10.7x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $86,574 | $43,287 | — | 10.6x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $92,799 | $46,399 | — | 10.1x |
| CELLULITIS WITHOUT MCC | 603 | $67,721 | $33,860 | — | 10x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $77,918 | $38,959 | — | 9.4x |
| DIABETES WITH CC | 638 | $61,926 | $30,963 | — | 9.3x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $71,237 | $35,619 | — | 9.2x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $61,264 | $30,632 | — | 9.2x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $91,228 | $45,614 | — | 9.2x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $94,089 | $47,044 | — | 9.1x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $155,516 | $77,758 | — | 9.1x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $52,912 | $26,456 | — | 9x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | 191 | $60,746 | $30,373 | — | 9x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC | 660 | $103,344 | $51,672 | — | 8.6x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $138,715 | $69,358 | — | 8.4x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $89,118 | $44,559 | — | 8.3x |
| RENAL FAILURE WITH CC | 683 | $58,318 | $29,159 | — | 8.1x |
| RENAL FAILURE WITH MCC | 682 | $104,436 | $52,218 | — | 8x |
| PERIPHERAL VASCULAR DISORDERS WITH CC | 300 | $69,495 | $34,747 | — | 7.9x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $79,667 | $39,834 | — | 7.8x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $73,152 | $36,576 | — | 7.7x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $119,917 | $59,959 | — | 7.5x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $128,183 | $64,092 | — | 7.5x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $95,052 | $47,526 | — | 7.5x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $78,495 | $39,247 | — | 7.3x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | 092 | $56,734 | $28,367 | — | 7.2x |
| ENDOCRINE DISORDERS WITH MCC | 643 | $104,232 | $52,116 | — | 7.2x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $78,020 | $39,010 | — | 6.8x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $239,168 | $119,584 | — | 5.9x |
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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