How many shoppable procedure prices are published for The Outer Banks Hospital, Inc?

The Outer Banks Hospital, Inc in Nags Head, NC currently has 92 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do The Outer Banks Hospital, Inc's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, The Outer Banks Hospital, Inc's median negotiated commercial rate is 1.7× the regionally adjusted fair BaseRate benchmark.

What is The Outer Banks Hospital, Inc's CMS Care Compare overall star rating?

CMS Care Compare assigns The Outer Banks Hospital, Inc an overall hospital quality rating of 4 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Critical Access Hospital Voluntary non-profit - Private 21 Beds · rural Updated: 2026-04-01

The Outer Banks Hospital, Inc

4800 South Croatan Highway, Nags Head, NC 27959 · 92 Priced Procedures · 77% Patient Recommendation

CMS Overall Rating 4 / 5 Stars

High Markup · Shop Alternatives

1.69×vs. Fair Market Price

Typical commercial prices here are +69% above the fair benchmark (1.69×) even after accounting for local nurse/doctor wages and patient complexity.

81/100 · Corroborated

81/100Self-Pay Cash Beats Insurance 66% of the Time

File Completeness66

Price Logic93

Peer Alignment63

Clean Billing84

Real Cash Discount100

High-Markup · Check Safety

4-Star CMS clinical quality rating paired with 1.69× fair market pricing.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

The Outer Banks Hospital, Inc prices routine shoppable procedures near 0.6× Medicare (p50 1.71×) while skewing captive emergency, lab, and upper-quartile codes to 1.8× Medicare (p75 1.78×, +4% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#61 of 69 in NC · 86th State Percentile#2,870 of 3,385 in U.S. · 84th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.50× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 66% of shoppable procedures (99/100 Cash Honesty)
4-Star CMS clinical rating with 77% patient recommendation (71/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (58.7% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.69× 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.
Captive ER (0.9×) & laboratory (3.0×) services average 3.00× higher multiples than routine shoppable care (0.6×)
Even at low-cost facilities (1.69× 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 10,000) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

0.6× Medicare

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

Back-Door Captive & ER3.00× Divergence

1.8× Medicare

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

Quantile Tail Spread+4% Upper Tail

Q25 1.50× · Q50 1.71× · Q75 1.78×

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

0.6× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.8× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.6× MedicareFair

Back-Door Captive ER VisitsBack-Door Captive

0.9× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

3.0× MedicareFair

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

0.7× MedicareGood

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

66% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 71/100Fair

Procedure Prices at The Outer Banks Hospital, Inc

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 92 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	$83,280	$49,251	$30,775	unverified
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$26,429	$30,895	$19,432	1.6×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$18,338	$29,820	$19,087	unverified
Heart stent placement (inpatient stay) MS-DRG Code: `322`	$49,450	$27,747	$17,936	1.5×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$19,286	$10,800	$8,223	1.3×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$5,410	$5,410	$448	12.1×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$4,512	$4,512	$303	14.9×
MRI, knee or other leg joint CPT Code: `73721`	$3,863	$3,863	$369	10.5×
MRI, brain (with and without contrast) CPT Code: `70553`	$3,478	$3,478	$511	6.8×
Rabies immune globulin HCPCS Code: `90375`	$2,962	$2,962	$322	9.2×
MRI, brain (no contrast) CPT Code: `70551`	$2,671	$2,671	$343	7.8×
CT scan, head (with and without contrast) CPT Code: `70470`	$2,615	$2,615	$258	10.1×
Ultrasound, pelvis CPT Code: `76856`	$2,420	$2,420	$130	18.6×
MRI, lower back (no contrast) CPT Code: `72148`	$2,327	$2,327	$338	6.9×
Hepatitis B immune globulin HCPCS Code: `90371`	$1,911	$1,911	$151	12.7×
CT scan, pelvis CPT Code: `72192`	$1,889	$1,889	$163	11.6×
CT scan, sinuses CPT Code: `70486`	$1,900	$1,900	$166	11.4×
CT scan, chest (no contrast) CPT Code: `71250`	$1,793	$1,793	$167	10.7×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,432	$1,432	$169	8.5×
Ultrasound, abdomen (complete) CPT Code: `76700`	$1,375	$1,375	$134	10.3×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,305	$1,305	$168	7.8×
Ultrasound, abdomen (limited) CPT Code: `76705`	$1,254	$1,254	$126	10.0×
Ultrasound, thyroid and neck CPT Code: `76536`	$1,090	$1,090	$132	8.3×
CT scan, head (with contrast) CPT Code: `70460`	$1,062	$1,062	$242	4.4×
Blood transfusion CPT Code: `36430`	$907	$907	$498	1.8×
CT scan, head (no contrast) CPT Code: `70450`	$817	$817	$160	5.1×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$822	$822	$272	3.0×
X-ray, lower back CPT Code: `72110`	$742	$742	$112	6.6×
X-ray, ankle CPT Code: `73610`	$628	$628	$93	6.8×
X-ray, foot CPT Code: `73630`	$613	$613	$92	6.7×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$553	$553	$583	0.9×
X-ray, shoulder CPT Code: `73030`	$526	$526	$92	5.7×
X-ray, hand CPT Code: `73130`	$517	$517	$93	5.6×
X-ray, chest (two views) CPT Code: `71046`	$395	$395	$93	4.2×
X-ray, neck (cervical spine) CPT Code: `72040`	$385	$385	$93	4.1×
Speech therapy (language evaluation) CPT Code: `92507`	$347	$347	$86	4.0×
Speech therapy (group session) CPT Code: `92508`	$317	$317	$27	11.7×
X-ray, pelvis CPT Code: `72170`	$329	$329	$110	3.0×
X-ray, hip CPT Code: `73502`	$292	$292	$93	3.1×
Electrical stimulation therapy HCPCS Code: `G0283`	$224	$224	$14	16.0×
X-ray, chest (single view) CPT Code: `71045`	$204	$204	$92	2.2×
Breathing treatment (nebulizer) CPT Code: `94640`	$158	$158	$201	0.8×
Physical therapy (manual therapy) CPT Code: `97140`	$123	$123	$34	3.6×
Physical therapy (functional capacity test) CPT Code: `97750`	$123	$123	$38	3.2×
Physical therapy (gait training) CPT Code: `97116`	$106	$106	$33	3.2×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$105	$105	$35	3.0×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$114	$114	$38	3.0×
Occupational therapy (self-care training) CPT Code: `97535`	$114	$114	$38	3.0×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$119	$119	$40	3.0×
Prosthetic fitting and training CPT Code: `97761`	$108	$108	$45	2.4×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$664	$105	$148	0.7×
Screening mammogram (both breasts) CPT Code: `77067`	$368	$86	$123	0.7×
Typhoid vaccine HCPCS Code: `90675`	$2,612	$2,612	$347	7.5×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$1,535	$1,535	$203	7.6×
Pneumococcal vaccine HCPCS Code: `90732`	$939	$939	$140	6.7×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$768	$768	$111	6.9×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$384	$384	$56	6.9×
Hepatitis B vaccine HCPCS Code: `90744`	$235	$235	$37	6.4×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$228	$228	$39	5.8×
Flu vaccine (high dose) HCPCS Code: `90656`	$166	$166	$25	6.6×
Blood test, vitamin D CPT Code: `82306`	$194	$54	$31	1.7×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$79	$79	$64	1.2×
Orthotic fitting and training CPT Code: `97760`	$50	$50	$51	1.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$60	$6	$3	2.0×
Blood test, lipase CPT Code: `83690`	$127	$13	$7	1.9×
Blood test, clotting time (PTT) CPT Code: `85730`	$15	$11	$6	1.8×
Blood test, calcium CPT Code: `82310`	$46	$9	$5	1.8×
Blood test, creatinine (kidney) CPT Code: `82565`	$56	$9	$5	1.8×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$123	$18	$10	1.8×
Blood test, PSA (prostate screen) CPT Code: `84153`	$73	$34	$19	1.8×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$122	$25	$14	1.8×
Blood test, ferritin (iron stores) CPT Code: `82728`	$149	$25	$14	1.8×
Culture, bacterial CPT Code: `87070`	$118	$16	$9	1.8×
Blood test, vitamin B12 CPT Code: `82607`	$127	$28	$16	1.8×
Blood test, glucose (blood sugar) CPT Code: `82947`	$46	$7	$4	1.8×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$58	$7	$4	1.8×
Blood test, complete blood count (CBC) CPT Code: `85025`	$119	$14	$8	1.8×
Hepatitis C antibody test CPT Code: `86803`	$105	$26	$15	1.7×
Culture, blood CPT Code: `87040`	$161	$19	$11	1.7×
Blood test, amylase CPT Code: `82150`	$118	$12	$7	1.7×
Blood test, magnesium CPT Code: `83735`	$48	$12	$7	1.7×
Blood test, basic metabolic panel CPT Code: `80048`	$161	$15	$9	1.7×
Blood test, liver function panel CPT Code: `80076`	$236	$15	$9	1.7×
Blood test, thyroid (TSH) CPT Code: `84443`	$132	$30	$18	1.7×
Blood test, potassium CPT Code: `84132`	$36	$8	$5	1.6×
Blood test, sodium CPT Code: `84295`	$40	$8	$5	1.6×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$50	$7	$5	1.4×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$145	$15	$11	1.4×
Blood test, hemoglobin CPT Code: `85018`	$10	$4	$3	1.3×
Blood antibody screen CPT Code: `86850`	$105	$21	$46	0.5×
Diagnostic procedure preparation HCPCS Code: `G0279`	$81	$15	$35	0.4×
Hospital observation (per hour) HCPCS Code: `G0378`	$19	$19	$86	0.2×

Showing top 25 high-impact procedures of 92 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 58.7%

Audit a Bill or Quote at The Outer Banks Hospital, Inc (Zero PHI Required)

CMS CCN: 341324

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash $83,280

Insurer Median $49,251

1. Amount on Your Bill or Quote ($) Pre-filled with The Outer Banks Hospital, Inc’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 501(r) AGB Cap: $87,296 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $87,296

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (58.7% of gross = $87,296).

Step 2 · Cash vs. Insurance Arbitrage Save $65,435 Paying Cash

Self-Pay Cash Rate ($83,280) Beats Your Bill

The Outer Banks Hospital, Inc's published 45 CFR § 180 self-pay cash rate is $83,280 (vs. $49,251 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$117,940 Above Fair BaseRate

Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)

Your bill ($148,715) is $117,940 above the denoised Fair BaseRate ($30,775) and 6.3× the $23,504 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) 501(c)(3) Nonprofit Hospital

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

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (58.7% 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.

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 Composite71/100

Would Recommend77%

Rated 9 or 10 (HCAHPS)76%

Median ER Wait213 min

Left ER Before Seen2%

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

Source: CMS Hospital Care Compare (276 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

Regional Value & Quality Leader Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for The Outer Banks Hospital, Inc.

Price Index: 1.00× regional baseline

Quality: 69/100 CMS composite

Median Household Income$81,214U.S. Census ACS

Local Uninsured Share8.9%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 81/100 · Corroborated CMS CCN 341324

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

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 341324) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-04-01

Validated Rate Rows5,404 (CMS v3.0.0)

File Integrity DigestVerified · CCN 341324

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