Sullivan County Community Hospital
2200 N Section St, Sullivan, IN 47882 · 103 Priced Procedures · 72% Patient Recommendation
Typical commercial prices here are +21% above the fair benchmark (1.21×) even after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Consolidated System Premium Pricer
Operating in a concentrated regional market (CBSA HHI 4,720), Sullivan County Community Hospital commands a 1.21× BaseRate commercial premium across insurers. Self-pay cash quotes, in-state peer hospitals, and freestanding outpatient facilities offer critical leverage against consolidated system pricing.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.56× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 21% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (68/100 safety score) with 72% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (34.5% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (1.21× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
- Commercial insurance median sits at 0.94× Fair BaseRate (1.4× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Even at low-cost facilities (1.21× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
- Consolidated metro market (HHI 4,720) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Sullivan County Community Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 103 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| C-section delivery (full package) CPT Code: 59510 | $2,263 | 0.8× |
| Total hip replacement CPT Code: 27130 | $2,238 | 0.2× |
| Total knee replacement CPT Code: 27447 | $2,206 | 0.2× |
| Vaginal delivery (full package) CPT Code: 59400 | $2,123 | 0.8× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $1,984 | unverified |
| Sleep study (overnight, in lab) CPT Code: 95810 | $913 | 0.9× |
| Blood transfusion CPT Code: 36430 | $764 | 1.5× |
| Rabies immune globulin HCPCS Code: 90375 | $715 | 2.2× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $494 | 0.1× |
| Bunion correction surgery CPT Code: 28296 | $478 | 0.1× |
| Psychiatric evaluation (first visit) CPT Code: 90791 | $361 | unverified |
| Electrocardiogram (EKG, tracing only) CPT Code: 93005 | $363 | unverified |
| X-ray, shoulder CPT Code: 73030 | $263 | 2.9× |
| X-ray, neck (cervical spine) CPT Code: 72040 | $263 | 2.8× |
| X-ray, pelvis CPT Code: 72170 | $263 | 2.4× |
| Family therapy session CPT Code: 90847 | $250 | 1.4× |
| Office visit, established patient (30-39 min) CPT Code: 99214 | $249 | unverified |
| Speech therapy (language evaluation) CPT Code: 92507 | $189 | 2.2× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $190 | 0.7× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $194 | 0.4× |
| Psychotherapy session (60 minutes) CPT Code: 90837 | $150 | 0.8× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $162 | 0.4× |
| Electrocardiogram (ECG/EKG) CPT Code: 93000 | $168 | unverified |
| Office visit, established patient (20-29 min) CPT Code: 99213 | $157 | unverified |
| Physical therapy (manual therapy) CPT Code: 97140 | $113 | 3.3× |
Audit a Bill or Quote at Sullivan County Community Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $2,037
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (34.5% of gross = $2,037).
Self-Pay Cash Rate ($4,427) Beats Your Bill
Sullivan County Community Hospital's published 45 CFR § 180 self-pay cash rate is $4,427 (vs. $2,263 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $2,975 Fair BaseRate ($2,473 Medicare)
Your bill ($5,903) is $2,928 above the denoised Fair BaseRate ($2,975) and 2.4× the $2,473 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (34.5% of gross charges)
Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare (55 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Sullivan County Community Hospital.
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.