How many shoppable procedure prices are published for Claiborne Medical Center?

Claiborne Medical Center in Tazewell, TN currently has 124 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Claiborne Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Claiborne Medical Center's median negotiated commercial rate is 1.0× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Acute Care Hospital Government - Local 26 Beds · rural Updated: 2026-08-05

Claiborne Medical Center

1850 Old Knoxville Highway, Tazewell, TN 37879 · 124 Priced Procedures · 63% Patient Recommendation

CMS Overall Rating No CMS Rating

Near Fair BaseRate Benchmark

1.03×vs. Fair Market Price

Typical commercial prices here are +3% above the fair benchmark (1.03×) even after accounting for local nurse/doctor wages and patient complexity.

91/100 · Verified

91/100Self-Pay Cash Beats Insurance 65% of the Time

File Completeness100

Price Logic91

Peer Alignment81

Clean Billing81

Real Cash Discount100

Regional Value Leader

4-Star CMS clinical quality rating paired with 1.03× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Claiborne Medical Center prices shoppable and inpatient services (1.2× to 1.2× Medicare, divergence 1.00×) in alignment with regional hospital peers (1.03× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#53 of 84 in TN · 61st State Percentile#1,442 of 3,385 in U.S. · 42nd National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.95× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 65% of shoppable procedures (99/100 Cash Honesty)
4-Star CMS clinical rating with 63% 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 (31.4% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.03× 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 1.02× Fair BaseRate (1.2× Medicare), so insured patients should always compare the self-pay cash price before paying.
Specialty infusion drugs (J-codes) average 1.1× Medicare — verify per-unit billing on itemized statements
Unnegotiated chargemaster list prices average 5.7× Medicare (20¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

1.2× Medicare

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

Back-Door Captive & ER1.00× Divergence

1.2× Medicare

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

Quantile Tail Spread+7% Upper Tail

Q25 0.95× · Q50 1.02× · Q75 1.09×

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

0.9× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.7× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.0× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

2.5× MedicareFair

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

1.1× MedicareGood

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

65% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 71/100Fair

Procedure Prices at Claiborne Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 124 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`	—	$34,254	$30,775	1.1×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$20,598	$19,087	1.1×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$20,453	$19,432	1.1×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$18,694	$17,936	1.0×
Total hip replacement CPT Code: `27130`	—	$13,099	$13,413	1.0×
Total knee replacement CPT Code: `27447`	—	$13,099	$13,523	1.0×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$8,267	$8,223	1.0×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$6,168	$6,109	1.0×
Breast lump removal CPT Code: `19120`	—	$3,995	$3,875	1.0×
Inguinal hernia repair CPT Code: `49505`	—	$3,653	$3,629	1.0×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$3,338	$3,372	1.0×
Bunion correction surgery CPT Code: `28296`	—	$3,338	$3,446	1.0×
Vaginal delivery (full package) CPT Code: `59400`	—	$2,812	$2,680	1.0×
C-section delivery (full package) CPT Code: `59510`	—	$2,812	$2,975	0.9×
Cataract surgery with lens implant CPT Code: `66984`	—	$2,355	$2,540	0.9×
Trauma team activation HCPCS Code: `G0390`	—	$1,360	$1,453	0.9×
Colonoscopy with biopsy CPT Code: `45380`	—	$1,221	$1,256	1.0×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$949	$981	1.0×
Upper endoscopy with biopsy CPT Code: `43239`	—	$925	$987	0.9×
Sleep study (overnight, in lab) CPT Code: `95810`	—	$876	$1,021	0.9×
Injection procedure for pain management HCPCS Code: `G0260`	—	$720	$855	0.8×
Rabies immune globulin HCPCS Code: `90375`	$833	$600	$322	1.9×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$350	$558	$583	1.0×
Psychological testing by technician CPT Code: `96138`	—	$456	$395	unverified
MRI, brain (with and without contrast) CPT Code: `70553`	$707	$427	$511	0.8×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$739	$356	$448	0.8×
MRI, brain (no contrast) CPT Code: `70551`	$496	$306	$343	0.9×
MRI, lower back (no contrast) CPT Code: `72148`	$658	$300	$338	0.9×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$739	$261	$303	0.9×
Breathing treatment (nebulizer) CPT Code: `94640`	$94	$223	$201	1.1×
Neurobehavioral status check CPT Code: `96116`	—	$220	$231	1.0×
CT scan, head (with contrast) CPT Code: `70460`	$349	$230	$242	1.0×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$212	$243	$272	0.9×
CT scan, head (with and without contrast) CPT Code: `70470`	$540	$230	$258	0.9×
MRI, knee or other leg joint CPT Code: `73721`	$651	$243	$369	0.7×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$92	$247	$148	unverified
CT scan, head (no contrast) CPT Code: `70450`	$349	$195	$160	1.2×
CT scan, sinuses CPT Code: `70486`	$323	$195	$166	unverified
CT scan, chest (no contrast) CPT Code: `71250`	$445	$196	$167	unverified
CT scan, neck (cervical spine) CPT Code: `72125`	$508	$214	$169	unverified
CT scan, lower back (lumbar spine) CPT Code: `72131`	$508	$213	$168	unverified
Psychotherapy session (45 minutes) CPT Code: `90834`	—	$181	$166	1.1×
Family therapy session CPT Code: `90847`	—	$181	$173	1.0×
Psychotherapy session (60 minutes) CPT Code: `90837`	—	$181	$181	1.0×
Psychiatric evaluation (first visit) CPT Code: `90791`	—	$181	$185	1.0×
CT scan, pelvis CPT Code: `72192`	$370	$195	$163	unverified
Screening mammogram (both breasts) CPT Code: `77067`	$66	$191	$123	unverified
Speech therapy (language evaluation) CPT Code: `92507`	$47	$162	$86	unverified
Diagnostic procedure preparation HCPCS Code: `G0279`	—	$164	$35	unverified
Psychological testing evaluation CPT Code: `96136`	—	$136	$128	1.1×
Hepatitis B immune globulin HCPCS Code: `90371`	$57	$134	$151	0.9×
Group therapy session CPT Code: `90853`	—	$104	$100	1.0×
X-ray, pelvis CPT Code: `72170`	$71	$107	$110	1.0×
X-ray, chest (single view) CPT Code: `71045`	$45	$89	$92	1.0×
X-ray, shoulder CPT Code: `73030`	$92	$89	$92	1.0×
X-ray, foot CPT Code: `73630`	$92	$89	$92	1.0×
X-ray, chest (two views) CPT Code: `71046`	$69	$89	$93	1.0×
X-ray, neck (cervical spine) CPT Code: `72040`	$53	$89	$93	1.0×
X-ray, hand CPT Code: `73130`	$92	$89	$93	1.0×
X-ray, hip CPT Code: `73502`	$127	$89	$93	1.0×
X-ray, ankle CPT Code: `73610`	$92	$89	$93	1.0×
X-ray, lower back CPT Code: `72110`	$116	$107	$112	1.0×
Ultrasound, abdomen (limited) CPT Code: `76705`	$136	$107	$126	0.8×
Ultrasound, pelvis CPT Code: `76856`	$102	$107	$130	0.8×
Ultrasound, thyroid and neck CPT Code: `76536`	$129	$107	$132	0.8×
Ultrasound, abdomen (complete) CPT Code: `76700`	$250	$107	$134	0.8×
Blood transfusion CPT Code: `36430`	$101	$101	$498	0.2×
Typhoid vaccine HCPCS Code: `90675`	$92	$313	$347	0.9×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$243	$203	1.2×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	—	$124	$111	1.1×
Pneumococcal vaccine HCPCS Code: `90732`	$44	$114	$140	0.8×
Hepatitis B vaccine HCPCS Code: `90744`	$22	$44	$37	1.2×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$23	$61	$56	1.1×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$26	$25	1.0×
Blood antibody screen CPT Code: `86850`	$17	$47	$46	1.0×
Flu vaccine injection HCPCS Code: `G0008`	$25	$48	$48	1.0×
Pneumonia vaccine injection HCPCS Code: `G0009`	$29	$48	$49	1.0×
Colorectal cancer screening HCPCS Code: `G0010`	$29	$48	$49	1.0×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$44	$60	$64	0.9×
Drug screening test HCPCS Code: `G0480`	$27	$81	$116	0.7×
Blood test, vitamin D CPT Code: `82306`	$17	$33	$31	1.1×
Office visit, established patient (30-39 min) CPT Code: `99214`	$44	$44	$123	0.4×
Blood test, calcium CPT Code: `82310`	$7	$7	$5	1.4×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$6	$4	$3	1.3×
Blood test, creatinine (kidney) CPT Code: `82565`	$4	$6	$5	1.2×
Blood test, clotting time (PTT) CPT Code: `85730`	$12	$7	$6	1.2×
Blood test, lipase CPT Code: `83690`	$14	$8	$7	1.1×
Blood test, complete blood count (CBC) CPT Code: `85025`	$23	$9	$8	1.1×
Blood test, basic metabolic panel CPT Code: `80048`	$31	$10	$9	1.1×
Culture, bacterial CPT Code: `87070`	$17	$10	$9	1.1×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	—	$30	$27	1.1×
Blood test, PSA (prostate screen) CPT Code: `84153`	$11	$21	$19	1.1×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$20	$11	$10	1.1×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$7	$22	$20	1.1×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$57	$12	$11	1.1×
Culture, blood CPT Code: `87040`	$21	$12	$11	1.1×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$27	$15	$14	1.1×
Blood test, ferritin (iron stores) CPT Code: `82728`	$27	$15	$14	1.1×
Hepatitis C antibody test CPT Code: `86803`	$7	$16	$15	1.1×
Blood test, vitamin B12 CPT Code: `82607`	$30	$17	$16	1.1×
Blood test, thyroid (TSH) CPT Code: `84443`	$34	$19	$18	1.1×
Flu vaccine (high dose) HCPCS Code: `90656`	—	$26	$25	1.0×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$13	$34	$39	0.9×
New patient office visit (30-44 min) CPT Code: `99203`	$39	$39	$110	0.4×
Blood test, liver function panel CPT Code: `80076`	$31	$9	$9	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$8	$4	$4	1.0×
Blood test, potassium CPT Code: `84132`	$9	$5	$5	1.0×
Blood test, sodium CPT Code: `84295`	$10	$5	$5	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$8	$4	$4	1.0×
Blood test, hemoglobin CPT Code: `85018`	$5	$3	$3	1.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$8	$5	$5	1.0×
Office visit, established patient (20-29 min) CPT Code: `99213`	$29	$29	$87	0.3×
Blood test, amylase CPT Code: `82150`	$22	$14	$7	unverified
Blood test, magnesium CPT Code: `83735`	$6	$12	$7	unverified
Physical therapy (therapeutic exercise) CPT Code: `97110`	$14	$14	$35	unverified
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$14	$14	$38	unverified
Physical therapy (gait training) CPT Code: `97116`	$14	$14	$33	unverified
Physical therapy (manual therapy) CPT Code: `97140`	$14	$14	$34	unverified
Occupational therapy (therapeutic activities) CPT Code: `97530`	$17	$17	$40	unverified
Occupational therapy (self-care training) CPT Code: `97535`	$14	$14	$38	unverified
Orthotic fitting and training CPT Code: `97760`	$14	$14	$51	unverified
Prosthetic fitting and training CPT Code: `97761`	$14	$14	$45	unverified
Electrical stimulation therapy HCPCS Code: `G0283`	$10	$10	$14	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	$15	$15	$86	unverified

Showing top 25 high-impact procedures of 124 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 31.4%

Audit a Bill or Quote at Claiborne Medical Center (Zero PHI Required)

CMS CCN: 440057

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $34,254

1. Amount on Your Bill or Quote ($) Pre-filled with Claiborne 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: $25,814 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $25,814

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (31.4% of gross = $25,814).

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

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Claiborne Medical Center'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 +$51,435 Above Fair BaseRate

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

Your bill ($82,210) is $51,435 above the denoised Fair BaseRate ($30,775) and 3.5× 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)

EIN: 464420358

Filing Period: 201410

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 (31.4% 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 Recommend63%

Rated 9 or 10 (HCAHPS)69%

Median ER Wait142 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 (143 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 Claiborne Medical Center.

Price Index: 0.74× regional baseline

Quality: 66/100 CMS composite

Median Household Income$46,587U.S. Census ACS

Local Uninsured Share9.9%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 91/100 · Verified CMS CCN 440057 EIN 464420358

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 440057) ↗ Verify IRS Form 990 (EIN 464420358) ↗ CMS HCRIS Cost Reports ↗

Published MRF File464420358_claiborne-medical-center_standardcharges.json

Publication / Vintage2026-08-05 · 302.01 MB

Validated Rate Rows5,629 (CMS v3.0.0)

File Integrity Digeste3bbe5ecf34be3f4798d…

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.

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