How many shoppable procedure prices are published for Novant Health Hilton Head Medical Center?

Novant Health Hilton Head Medical Center in Hilton Head Island, SC currently has 142 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Novant Health Hilton Head Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Novant Health Hilton Head Medical Center's median negotiated commercial rate is 0.9× the regionally adjusted fair BaseRate benchmark.

What is Novant Health Hilton Head Medical Center's CMS Care Compare overall star rating?

CMS Care Compare assigns Novant Health Hilton Head Medical Center an overall hospital quality rating of 2 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Other 93 Beds · urban Updated: 2026-03-12

Novant Health Hilton Head Medical Center

25 Hospital Center Blvd, Hilton Head Island, SC 29926 · 142 Priced Procedures · 52% Patient Recommendation

CMS Overall Rating 2 / 5 Stars

Good Deal · Below Fair Market

0.91×vs. Fair Market Price

Typical commercial prices here are 9% below the fair benchmark (0.91×) after accounting for local nurse/doctor wages and patient complexity.

82/100 · Corroborated

82/100Self-Pay Cash Beats Insurance 42% of the Time

File Completeness66

Price Logic99

Peer Alignment65

Clean Billing80

Real Cash Discount100

Regional Benchmark Tier

2-Star CMS clinical quality rating paired with 0.91× fair market pricing.

Behavioral Pricing FingerprintLow Shoppable & Low Captive Rates

Uniform Value Leader · Low-Cost Across Departments

Novant Health Hilton Head Medical Center maintains low, disciplined commercial pricing across both routine shoppable procedures (1.2× Medicare, p50 0.90× Fair BaseRate) and emergency/ancillary services (1.0× Medicare, p75 0.99× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.

#11 of 52 in SC · 19th State Percentile#741 of 3,385 in U.S. · 21st National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 9% below peer Fair BaseRate (0.91×)
Self-pay cash beats commercial insurance on 42% of shoppable procedures (99/100 Cash Honesty)
2-Star CMS clinical rating with 52% patient recommendation (57/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (29.5% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.5× markup over Medicare rates
Commercial insurance median sits at 0.90× Fair BaseRate (1.2× Medicare), so insured patients should always compare the self-pay cash price before paying.
Even at low-cost facilities (0.91× 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 4,049) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.2× Medicare

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

Back-Door Captive & ER0.83× Divergence

1.0× Medicare

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

Quantile Tail Spread+10% Upper Tail

Q25 0.79× · Q50 0.90× · Q75 0.99×

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

1.2× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.5× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.3× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.7× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.6× MedicareGood

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

0.9× MedicareGood

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

42% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

2 CMS · 57/100Elevated

Procedure Prices at Novant Health Hilton Head Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 142 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`	$48,554	$30,264	$30,775	1.0×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$26,077	$18,071	$19,432	0.9×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$15,394	$18,025	$19,087	0.9×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	$33,516	$16,517	$17,936	0.9×
Total hip replacement CPT Code: `27130`	$27,052	$12,180	$13,413	0.9×
Total knee replacement CPT Code: `27447`	$21,564	$12,180	$13,523	0.9×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$8,121	$7,304	$8,223	0.9×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$6,900	$5,848	$6,109	1.0×
Breast lump removal CPT Code: `19120`	$4,573	$3,787	$3,875	1.0×
Inguinal hernia repair CPT Code: `49505`	$1,926	$3,430	$3,629	0.9×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$3,614	$3,165	$3,372	unverified
Bunion correction surgery CPT Code: `28296`	$1,772	$3,135	$3,446	unverified
Cataract surgery with lens implant CPT Code: `66984`	$2,145	$2,254	$2,540	unverified
Vaginal delivery (full package) CPT Code: `59400`	—	$2,150	$2,680	0.8×
C-section delivery (full package) CPT Code: `59510`	—	$2,150	$2,975	0.7×
Trauma team activation HCPCS Code: `G0390`	$3,013	$1,289	$1,453	0.9×
Colonoscopy with biopsy CPT Code: `45380`	$833	$1,146	$1,256	0.9×
Colonoscopy (diagnostic) CPT Code: `45378`	$833	$891	$981	0.9×
Upper endoscopy with biopsy CPT Code: `43239`	$833	$886	$987	0.9×
Sleep study (overnight, in lab) CPT Code: `95810`	$2,430	$819	$1,021	0.8×
Injection procedure for pain management HCPCS Code: `G0260`	$796	$689	$855	0.8×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$964	$529	$583	unverified
Behavioral health counseling (group) HCPCS Code: `H0009`	—	$482	$269	unverified
Psychological testing by technician CPT Code: `96138`	$388	$424	$395	1.1×
Blood transfusion CPT Code: `36430`	$714	$431	$498	0.9×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$873	$358	$448	0.8×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,132	$368	$511	0.7×
Behavioral health residential care HCPCS Code: `H0011`	—	$314	$364	0.9×
Residential mental health treatment HCPCS Code: `H2036`	—	$322	$406	0.8×
Rabies immune globulin HCPCS Code: `90375`	$403	$268	$322	0.8×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$265	$25	unverified
Neurobehavioral status check CPT Code: `96116`	$520	$211	$231	0.9×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$274	$233	$272	0.9×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$534	$231	$303	0.8×
MRI, lower back (no contrast) CPT Code: `72148`	$660	$231	$338	0.7×
MRI, brain (no contrast) CPT Code: `70551`	$622	$231	$343	0.7×
MRI, knee or other leg joint CPT Code: `73721`	$622	$231	$369	0.6×
Breathing treatment (nebulizer) CPT Code: `94640`	$85	$204	$201	1.0×
Psychotherapy session (45 minutes) CPT Code: `90834`	$348	$172	$166	1.0×
Family therapy session CPT Code: `90847`	$529	$172	$173	1.0×
Psychotherapy session (60 minutes) CPT Code: `90837`	$348	$172	$181	1.0×
Psychiatric evaluation (first visit) CPT Code: `90791`	$348	$172	$185	0.9×
CT scan, head (with contrast) CPT Code: `70460`	$608	$179	$242	0.7×
CT scan, head (with and without contrast) CPT Code: `70470`	$597	$179	$258	0.7×
Speech therapy (language evaluation) CPT Code: `92507`	$129	$164	$86	unverified
Psychological testing evaluation CPT Code: `96136`	$161	$129	$128	1.0×
Hepatitis B immune globulin HCPCS Code: `90371`	$250	$127	$151	0.8×
Group therapy session CPT Code: `90853`	$208	$98	$100	1.0×
New patient office visit (30-44 min) CPT Code: `99203`	$136	$104	$110	0.9×
Office visit, established patient (30-39 min) CPT Code: `99214`	$146	$111	$123	0.9×
CT scan, head (no contrast) CPT Code: `70450`	$421	$109	$160	0.7×
CT scan, pelvis CPT Code: `72192`	$492	$109	$163	0.7×
CT scan, sinuses CPT Code: `70486`	$365	$109	$166	0.7×
CT scan, chest (no contrast) CPT Code: `71250`	$475	$109	$167	0.7×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$527	$109	$168	0.6×
X-ray, chest (single view) CPT Code: `71045`	$110	$83	$92	0.9×
X-ray, lower back CPT Code: `72110`	$107	$101	$112	0.9×
Diagnostic mammogram (both breasts) CPT Code: `77066`	—	$117	$148	0.8×
CT scan, neck (cervical spine) CPT Code: `72125`	$491	$109	$169	0.6×
X-ray, chest (two views) CPT Code: `71046`	$110	$83	$93	0.9×
X-ray, hip CPT Code: `73502`	$122	$83	$93	0.9×
X-ray, shoulder CPT Code: `73030`	$63	$81	$92	0.9×
X-ray, foot CPT Code: `73630`	$62	$81	$92	0.9×
X-ray, neck (cervical spine) CPT Code: `72040`	$64	$81	$93	0.9×
X-ray, hand CPT Code: `73130`	$63	$81	$93	0.9×
X-ray, ankle CPT Code: `73610`	$62	$81	$93	0.9×
Ultrasound, abdomen (limited) CPT Code: `76705`	$145	$101	$126	0.8×
Screening mammogram (both breasts) CPT Code: `77067`	$148	$97	$123	0.8×
Ultrasound, abdomen (complete) CPT Code: `76700`	$210	$103	$134	0.8×
Ultrasound, thyroid and neck CPT Code: `76536`	$216	$101	$132	0.8×
Behavioral health counseling (per session) HCPCS Code: `H0008`	—	$112	$257	0.4×
Behavioral health day treatment HCPCS Code: `H0010`	—	$121	$343	0.4×
X-ray, pelvis CPT Code: `72170`	$59	$100	$110	unverified
Ultrasound, pelvis CPT Code: `76856`	$150	$101	$130	unverified
Typhoid vaccine HCPCS Code: `90675`	$297	$297	$347	0.9×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$189	$203	0.9×
Drug screening test HCPCS Code: `G0480`	—	$114	$116	1.0×
Pneumococcal vaccine HCPCS Code: `90732`	$82	$121	$140	0.9×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	—	$93	$111	0.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$38	$55	$35	1.6×
Office visit, established patient (20-29 min) CPT Code: `99213`	$109	$79	$87	0.9×
Care planning with family CPT Code: `90887`	—	$76	$107	0.7×
Physical therapy (gait training) CPT Code: `97116`	$34	$48	$33	1.5×
Physical therapy (manual therapy) CPT Code: `97140`	$52	$48	$34	1.4×
Occupational therapy (self-care training) CPT Code: `97535`	$32	$50	$38	1.3×
Physical therapy (functional capacity test) CPT Code: `97750`	$37	$49	$38	1.3×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$37	$49	$40	1.2×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$56	$41	$38	1.1×
Blood antibody screen CPT Code: `86850`	$21	$48	$46	1.0×
Blood test, basic metabolic panel CPT Code: `80048`	$31	$9	$9	1.0×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$36	$11	$11	1.0×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$42	$14	$14	1.0×
Blood test, liver function panel CPT Code: `80076`	$38	$9	$9	1.0×
Blood test, vitamin D CPT Code: `82306`	$77	$31	$31	1.0×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$32	$27	$27	1.0×
Orthotic fitting and training CPT Code: `97760`	$47	$49	$51	1.0×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$51	$20	$20	1.0×
Flu vaccine injection HCPCS Code: `G0008`	$80	$45	$48	0.9×
Pneumonia vaccine injection HCPCS Code: `G0009`	$80	$45	$49	0.9×
Colorectal cancer screening HCPCS Code: `G0010`	$58	$45	$49	0.9×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$84	$58	$64	0.9×
Review of medical records for care CPT Code: `90889`	—	$67	$114	0.6×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	—	$40	$56	0.7×
Residential substance abuse treatment HCPCS Code: `H2035`	—	$60	$88	0.7×
Speech therapy (group session) CPT Code: `92508`	$52	$52	$27	unverified
Blood test, clotting time (PTT) CPT Code: `85730`	$22	$6	$6	1.0×
Hepatitis C antibody test CPT Code: `86803`	$60	$15	$15	1.0×
Culture, blood CPT Code: `87040`	$40	$11	$11	1.0×
Culture, bacterial CPT Code: `87070`	$33	$9	$9	1.0×
Hepatitis B vaccine HCPCS Code: `90744`	$40	$31	$37	0.8×
Flu vaccine (high dose) HCPCS Code: `90656`	$19	$20	$25	0.8×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	—	$29	$39	0.7×
Diagnostic procedure preparation HCPCS Code: `G0279`	—	$25	$35	0.7×
Prosthetic fitting and training CPT Code: `97761`	$40	$28	$45	0.6×
Hospital observation (per hour) HCPCS Code: `G0378`	—	$52	$86	0.6×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$12	$3	$3	1.0×
Blood test, amylase CPT Code: `82150`	$23	$7	$7	1.0×
Blood test, calcium CPT Code: `82310`	$18	$5	$5	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$19	$5	$5	1.0×
Blood test, vitamin B12 CPT Code: `82607`	$68	$16	$16	1.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	$54	$14	$14	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$14	$4	$4	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$37	$10	$10	1.0×
Blood test, lipase CPT Code: `83690`	$21	$7	$7	1.0×
Blood test, magnesium CPT Code: `83735`	$24	$7	$7	1.0×
Blood test, potassium CPT Code: `84132`	$18	$5	$5	1.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$77	$19	$19	1.0×
Behavioral health outpatient services HCPCS Code: `H2015`	—	$14	$16	0.9×
Extended office visit (prolonged) HCPCS Code: `G2212`	—	$22	$33	0.7×
Behavioral health living support HCPCS Code: `H2019`	—	$13	$34	0.4×
Behavioral health day program HCPCS Code: `H2012`	—	$36	$100	0.4×
Behavioral health assessment HCPCS Code: `H0001`	—	$44	$157	0.3×
Blood test, sodium CPT Code: `84295`	$16	$5	$5	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$16	$4	$4	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$27	$8	$8	1.0×
Blood test, thyroid (TSH) CPT Code: `84443`	$60	$17	$18	0.9×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$18	$4	$5	0.8×
Mental health services (assessment) HCPCS Code: `H0031`	—	$28	$140	0.2×
Blood test, hemoglobin CPT Code: `85018`	$11	$2	$3	0.7×
Mental health services (therapy) HCPCS Code: `H0032`	—	$11	$65	0.2×
Community mental health services HCPCS Code: `H0038`	—	$2	$16	0.1×
Electrical stimulation therapy HCPCS Code: `G0283`	$11	$11	$14	unverified

Showing top 25 high-impact procedures of 142 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 29.5%

Audit a Bill or Quote at Novant Health Hilton Head Medical Center (Zero PHI Required)

CMS CCN: 420080

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash $48,554

Insurer Median $30,264

1. Amount on Your Bill or Quote ($) Pre-filled with Novant Health Hilton Head Medical Center’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: $21,427 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $21,427

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (29.5% of gross = $21,427).

Step 2 · Cash vs. Insurance Arbitrage Save $24,080 Paying Cash

Self-Pay Cash Rate ($48,554) Beats Your Bill

Novant Health Hilton Head Medical Center's published 45 CFR § 180 self-pay cash rate is $48,554 (vs. $30,264 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$41,859 Above Fair BaseRate

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

Your bill ($72,634) is $41,859 above the denoised Fair BaseRate ($30,775) and 3.1× 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 (29.5% 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.

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 Overall2/5 Stars (2/5)

Safety Composite57/100

Would Recommend52%

Rated 9 or 10 (HCAHPS)55%

Median ER Wait172 min

Left ER Before Seen0%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate3.7%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

C. diff Hospital-Onset Infectionbetter

Source: CMS Hospital Care Compare (619 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 Quality & Price Benchmark

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Novant Health Hilton Head Medical Center.

Price Index: 1.00× regional baseline

Quality: 46/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Cigna

-47.9%

Median Household Income$84,819U.S. Census ACS

Local Uninsured Share8.4%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 82/100 · Corroborated CMS CCN 420080

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 420080) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-03-12

Validated Rate Rows3,405 (CMS v3.0.0)

File Integrity DigestVerified · CCN 420080

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