Upper Valley Medical Center
Upper Valley Medical Center in Troy, Ohio charges 5.9x the Medicare reimbursement rate across 42 analyzed procedures, reflecting typical pricing patterns for nonprofit healthcare facilities.
Troy, OH 45373 · Acute Care Hospitals · CMS Rating: 4/5
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
D
High
Avg markup vs Medicare
5.86x
Charge / Medicare rate
Max markup
9.67x
Worst procedure
Procedures analyzed
42
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 |
|---|---|---|---|---|---|
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $26,325 | $13,162 | — | 9.7x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $97,481 | $48,741 | — | 8.8x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $121,953 | $60,977 | — | 8.6x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $51,357 | $25,679 | — | 7x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $37,864 | $18,932 | — | 7x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $61,164 | $30,582 | — | 6.9x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $49,953 | $24,977 | — | 6.9x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $40,779 | $20,389 | — | 6.6x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $27,289 | $13,644 | — | 6.4x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $27,405 | $13,702 | — | 6.4x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $69,911 | $34,955 | — | 6.4x |
| SYNCOPE AND COLLAPSE | 312 | $28,279 | $14,139 | — | 6.3x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $46,084 | $23,042 | — | 6.3x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $28,612 | $14,306 | — | 6.3x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $34,366 | $17,183 | — | 6.2x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $26,336 | $13,168 | — | 6x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $26,261 | $13,131 | — | 6x |
| RENAL FAILURE WITH CC | 683 | $29,975 | $14,987 | — | 5.9x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $39,683 | $19,841 | — | 5.8x |
| GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC | 390 | $18,635 | $9,318 | — | 5.7x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $30,663 | $15,332 | — | 5.7x |
| SIGNS AND SYMPTOMS WITHOUT MCC | 948 | $27,400 | $13,700 | — | 5.6x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $54,779 | $27,389 | — | 5.6x |
| BRONCHITIS AND ASTHMA WITH CC/MCC | 202 | $29,877 | $14,938 | — | 5.6x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC | 314 | $61,353 | $30,677 | — | 5.5x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $48,100 | $24,050 | — | 5.5x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $66,477 | $33,239 | — | 5.4x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $27,834 | $13,917 | — | 5.4x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $23,514 | $11,757 | — | 5.4x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $58,848 | $29,424 | — | 5.3x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $36,438 | $18,219 | — | 5.3x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC | 699 | $32,994 | $16,497 | — | 5.2x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | 394 | $27,116 | $13,558 | — | 5.1x |
| COAGULATION DISORDERS | 813 | $47,461 | $23,731 | — | 4.9x |
| CELLULITIS WITHOUT MCC | 603 | $21,537 | $10,768 | — | 4.9x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $32,820 | $16,410 | — | 4.9x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $45,401 | $22,700 | — | 4.9x |
| RENAL FAILURE WITH MCC | 682 | $42,999 | $21,500 | — | 4.8x |
| ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY | 884 | $40,007 | $20,003 | — | 4.4x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $113,269 | $56,634 | — | 4.1x |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC | 057 | $28,717 | $14,358 | — | 3.9x |
| PSYCHOSES | 885 | $26,054 | $13,027 | — | 3.7x |
How UPPER VALLEY MEDICAL CENTER compares to nearby hospitals
Comparison based on average markup ratios from federal hospital pricing data (FY 2024). Chargemaster rates are gross charges — they are not what most insured patients pay. Actual costs depend on your insurance plan, negotiated rates, and coverage terms. This comparison is for informational purposes only and does not constitute medical, financial, or legal advice. Verify costs directly with your provider and insurer.
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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