How many shoppable procedure prices are published for Highlands Cashiers Hospital?

Highlands Cashiers Hospital in Highlands, NC currently has 106 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Highlands Cashiers Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Highlands Cashiers Hospital's median negotiated commercial rate is 1.2× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Voluntary non-profit - Private 24 Beds · rural Updated: 2026-09-01

Highlands Cashiers Hospital

190 Hospital Drive, Highlands, NC 28741 · 106 Priced Procedures · 77% Patient Recommendation

CMS Overall Rating No CMS Rating

Above Fair Market · Negotiate

1.21×vs. Fair Market Price

Typical commercial prices here are +21% above the fair benchmark (1.21×) even after accounting for local nurse/doctor wages and patient complexity.

64/100 · Caution

64/100Self-Pay Cash Beats Insurance 4% of the Time

File Completeness85

Price Logic82

Peer Alignment48

Clean Billing87

Real Cash Discount6

High Quality · Fair Price

4-Star CMS clinical quality rating paired with 1.21× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Highlands Cashiers Hospital prices shoppable and inpatient services (1.3× to 1.2× Medicare, divergence 0.92×) in alignment with regional hospital peers (1.21× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#44 of 69 in NC · 62nd State Percentile#2,042 of 3,385 in U.S. · 60th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.02× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 4% of shoppable procedures (25/100 Cash Honesty)
4-Star CMS clinical rating with 77% patient recommendation (74/100 safety score)
Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling

Watchout

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 1.23× Fair BaseRate (1.3× 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.
Unnegotiated chargemaster list prices average 13.0× Medicare (16¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

1.3× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER0.92× Divergence

1.2× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+3% Upper Tail

Q25 1.02× · Q50 1.23× · Q75 1.27×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

1.3× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.9× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.1× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

0.6× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.0× MedicareGood

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

0.6× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

4% Cash Edge · 25/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 74/100Fair

Procedure Prices at Highlands Cashiers Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 106 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Total hip replacement CPT Code: `27130`	—	$14,000	$13,413	1.0×
Total knee replacement CPT Code: `27447`	—	$14,000	$13,523	1.0×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$9,586	$9,586	$448	21.4×
MRI, brain (with and without contrast) CPT Code: `70553`	$8,180	$8,180	$511	16.0×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$7,710	$7,710	$303	25.4×
Rabies immune globulin HCPCS Code: `90375`	$6,570	$6,570	$322	20.4×
MRI, lower back (no contrast) CPT Code: `72148`	$5,913	$5,913	$338	17.5×
MRI, knee or other leg joint CPT Code: `73721`	$5,848	$5,848	$369	15.8×
MRI, brain (no contrast) CPT Code: `70551`	$5,781	$5,781	$343	16.9×
CT scan, head (with and without contrast) CPT Code: `70470`	$5,732	$5,732	$258	22.2×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$5,198	$3,372	1.5×
Bunion correction surgery CPT Code: `28296`	—	$5,198	$3,446	1.5×
Inguinal hernia repair CPT Code: `49505`	—	$5,198	$3,629	1.4×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$5,198	$6,109	0.9×
Sleep study (overnight, in lab) CPT Code: `95810`	$4,888	$4,888	$1,021	4.8×
CT scan, neck (cervical spine) CPT Code: `72125`	$4,268	$4,268	$169	25.3×
CT scan, head (with contrast) CPT Code: `70460`	$4,273	$4,273	$242	17.7×
CT scan, head (no contrast) CPT Code: `70450`	$3,960	$3,960	$160	24.8×
CT scan, sinuses CPT Code: `70486`	$3,960	$3,960	$166	23.9×
Breast lump removal CPT Code: `19120`	—	$3,875	$3,875	1.0×
CT scan, pelvis CPT Code: `72192`	$3,824	$3,824	$163	23.5×
CT scan, chest (no contrast) CPT Code: `71250`	$3,824	$3,824	$167	22.9×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$3,824	$3,824	$168	22.8×
Hepatitis B immune globulin HCPCS Code: `90371`	$3,756	$3,756	$151	24.9×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,791	$2,791	$583	4.8×
Cataract surgery with lens implant CPT Code: `66984`	—	$2,675	$2,540	1.1×
Vaginal delivery (full package) CPT Code: `59400`	—	$2,675	$2,680	1.0×
C-section delivery (full package) CPT Code: `59510`	—	$2,675	$2,975	0.9×
Upper endoscopy with biopsy CPT Code: `43239`	—	$2,675	$987	unverified
Colonoscopy (diagnostic) CPT Code: `45378`	—	$2,675	$981	unverified
Colonoscopy with biopsy CPT Code: `45380`	—	$2,675	$1,256	unverified
Ultrasound, abdomen (complete) CPT Code: `76700`	$1,946	$1,946	$134	14.5×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,789	$1,789	$272	6.6×
Ultrasound, pelvis CPT Code: `76856`	$1,552	$1,552	$130	11.9×
Blood transfusion CPT Code: `36430`	$1,496	$1,496	$498	unverified
Ultrasound, abdomen (limited) CPT Code: `76705`	$1,254	$1,254	$126	10.0×
Ultrasound, thyroid and neck CPT Code: `76536`	$1,244	$1,244	$132	9.4×
X-ray, hip CPT Code: `73502`	$1,110	$1,110	$93	11.9×
X-ray, neck (cervical spine) CPT Code: `72040`	$983	$983	$93	10.6×
X-ray, lower back CPT Code: `72110`	$842	$842	$112	7.5×
X-ray, chest (two views) CPT Code: `71046`	$655	$655	$93	7.0×
X-ray, pelvis CPT Code: `72170`	$652	$652	$110	5.9×
X-ray, chest (single view) CPT Code: `71045`	$557	$557	$92	6.1×
X-ray, foot CPT Code: `73630`	$530	$530	$92	5.8×
X-ray, hand CPT Code: `73130`	$530	$530	$93	5.7×
X-ray, ankle CPT Code: `73610`	$530	$530	$93	5.7×
X-ray, shoulder CPT Code: `73030`	$511	$511	$92	5.6×
Office visit, established patient (30-39 min) CPT Code: `99214`	$523	$523	$123	4.3×
Office visit, established patient (20-29 min) CPT Code: `99213`	$436	$436	$87	5.0×
New patient office visit (30-44 min) CPT Code: `99203`	$436	$436	$110	4.0×
Breathing treatment (nebulizer) CPT Code: `94640`	$359	$359	$201	1.8×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$188	$188	$64	2.9×
Speech therapy (language evaluation) CPT Code: `92507`	$210	$210	$86	2.4×
Occupational therapy (self-care training) CPT Code: `97535`	$150	$150	$38	3.9×
Physical therapy (functional capacity test) CPT Code: `97750`	$131	$131	$38	3.4×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$125	$125	$38	3.3×
Orthotic fitting and training CPT Code: `97760`	$146	$146	$51	2.9×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$114	$114	$35	3.3×
Physical therapy (manual therapy) CPT Code: `97140`	$92	$92	$34	2.7×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$102	$102	$40	2.5×
Physical therapy (gait training) CPT Code: `97116`	$84	$84	$33	2.5×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$484	$103	$148	0.7×
Screening mammogram (both breasts) CPT Code: `77067`	$474	$85	$123	0.7×
Typhoid vaccine HCPCS Code: `90675`	$3,678	$3,678	$347	10.6×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$882	$882	$203	4.3×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$772	$772	$111	7.0×
Pneumococcal vaccine HCPCS Code: `90732`	$606	$606	$140	4.3×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$460	$460	$56	8.2×
Flu vaccine (high dose) HCPCS Code: `90656`	$385	$385	$25	15.4×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$304	$304	$39	7.8×
Hepatitis B vaccine HCPCS Code: `90744`	$211	$211	$37	5.7×
Flu vaccine injection HCPCS Code: `G0008`	$102	$102	$48	2.1×
Pneumonia vaccine injection HCPCS Code: `G0009`	$98	$98	$49	2.0×
Drug screening test HCPCS Code: `G0480`	—	$76	$116	0.7×
Electrical stimulation therapy HCPCS Code: `G0283`	$40	$40	$14	2.9×
Blood test, vitamin D CPT Code: `82306`	—	$38	$31	1.2×
Colorectal cancer screening HCPCS Code: `G0010`	$149	$48	$49	1.0×
Blood test, calcium CPT Code: `82310`	—	$7	$5	1.4×
Blood test, creatinine (kidney) CPT Code: `82565`	—	$7	$5	1.4×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$10	$4	$3	1.3×
Blood test, clotting time (PTT) CPT Code: `85730`	—	$8	$6	1.3×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$40	$13	$10	1.3×
Blood test, ferritin (iron stores) CPT Code: `82728`	—	$18	$14	1.3×
Blood test, lipase CPT Code: `83690`	—	$9	$7	1.3×
Blood test, magnesium CPT Code: `83735`	—	$9	$7	1.3×
Hepatitis C antibody test CPT Code: `86803`	—	$19	$15	1.3×
Blood test, PSA (prostate screen) CPT Code: `84153`	—	$24	$19	1.3×
Blood test, vitamin B12 CPT Code: `82607`	—	$20	$16	1.3×
Blood test, glucose (blood sugar) CPT Code: `82947`	—	$5	$4	1.3×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	—	$5	$4	1.3×
Blood test, complete blood count (CBC) CPT Code: `85025`	—	$10	$8	1.3×
Culture, bacterial CPT Code: `87070`	—	$11	$9	1.2×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	—	$17	$14	1.2×
Blood test, potassium CPT Code: `84132`	$107	$6	$5	1.2×
Blood test, sodium CPT Code: `84295`	$155	$6	$5	1.2×
Culture, blood CPT Code: `87040`	—	$13	$11	1.2×
Blood test, thyroid (TSH) CPT Code: `84443`	—	$21	$18	1.2×
Hospital observation (per hour) HCPCS Code: `G0378`	$38	$38	$86	0.4×
Blood test, amylase CPT Code: `82150`	—	$8	$7	1.1×
Blood test, basic metabolic panel CPT Code: `80048`	—	$10	$9	1.1×
Blood test, liver function panel CPT Code: `80076`	—	$10	$9	1.1×
Blood test, comprehensive metabolic panel CPT Code: `80053`	—	$11	$11	1.0×
Blood test, hemoglobin CPT Code: `85018`	$71	$3	$3	1.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$5	$5	$5	1.0×
Diagnostic procedure preparation HCPCS Code: `G0279`	$67	$15	$35	0.4×
Blood antibody screen CPT Code: `86850`	—	$15	$46	0.3×

Showing top 25 high-impact procedures of 106 total

Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at Highlands Cashiers Hospital (Zero PHI Required)

CMS CCN: 341316

CPT 27130

Select Procedure to Audit:

Fair BaseRate™ $13,413

Medicare Rate $13,117

Self-Pay Cash Request Quote

Insurer Median $14,000

1. Amount on Your Bill or Quote ($) Pre-filled with Highlands Cashiers Hospital’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 274% of 2026 FPL

Above Standard 400% FPL Financial-Assistance Ceiling

At 274% FPL, you exceed the standard 400% FPL tier, though medical-hardship caps (when bills exceed 10% of annual income) may still apply.

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Highlands Cashiers Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$20,187 Above Fair BaseRate

Negotiate Toward $13,413 Fair BaseRate ($13,117 Medicare)

Your bill ($33,600) is $20,187 above the denoised Fair BaseRate ($13,413) and 2.6× the $13,117 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) For-Profit / Non-501(c)(3)

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

EIN: 832048950

Public IRS & CMS ownership records classify Highlands Cashiers Hospital as a non-501(c)(3) facility. Federal 26 U.S.C. § 501(r) statutory charity-care caps apply specifically to tax-exempt nonprofit hospitals, though state hospital fair-pricing statutes and prompt-pay self-pay discounts may still apply.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall4/5 Stars (4/5)

Safety Composite74/100

Would Recommend77%

Rated 9 or 10 (HCAHPS)82%

Median ER Wait104 min

Left ER Before Seen0%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

C. diff Hospital-Onset Infectionsame

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Highlands Cashiers Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2025-06-04·administrative_or_closure
Met Requirements
Recorded
2025-05-07·administrative_or_closure
Met Requirements
Recorded
2023-10-25·administrative_or_closure
Closure Notice
Recorded
2023-07-10·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (139 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Higher-Quality, Above-Median Price Tier Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Highlands Cashiers Hospital.

Price Index: 1.38× regional baseline

Quality: 71/100 CMS composite

Median Household Income$53,298U.S. Census ACS

Local Uninsured Share14.4%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 64/100 · Caution CMS CCN 341316 EIN 832048950

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 341316) ↗ Verify IRS Form 990 (EIN 832048950) ↗ CMS HCRIS Cost Reports ↗

Published MRF File83-2048950_HIGHLANDS-CASHIERS-HOSPITAL_standardcharges.json

Publication / Vintage2026-09-01 · 405.87 MB

Validated Rate Rows2,590 (CMS v3.0.0)

File Integrity Digest53185d9b304f7777abf1…

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.

Submit MRF Update Correction Policy