How many shoppable procedure prices are published for Erlanger Bledsoe Hospital?

Erlanger Bledsoe Hospital in Pikeville, TN currently has 128 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Erlanger Bledsoe Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Erlanger Bledsoe Hospital's median negotiated commercial rate is 1.0× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Government - Hospital District or Authority 25 Beds · rural Updated: 2026-01-25

Erlanger Bledsoe Hospital

71 Wheelertown Avenue, Pikeville, TN 37367 · 128 Priced Procedures · 82% Patient Recommendation

CMS Overall Rating No CMS Rating

Near Fair BaseRate Benchmark

1.00×vs. Fair Market Price

Typical commercial prices here match the fair market benchmark (1.00×) after accounting for local nurse/doctor wages and patient complexity.

82/100 · Corroborated

82/100Self-Pay Cash Beats Insurance 49% of the Time

File Completeness60

Price Logic90

Peer Alignment67

Clean Billing96

Real Cash Discount100

Regional Value Leader

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Erlanger Bledsoe Hospital prices shoppable and inpatient services (0.9× to 1.2× Medicare, divergence 1.33×) in alignment with regional hospital peers (1.00× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#46 of 84 in TN · 53rd State Percentile#1,303 of 3,385 in U.S. · 38th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.74× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 49% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (73/100 safety score) with 82% patient recommendation
Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.1× markup over Medicare rates
Captive ER (1.5×) & laboratory (1.5×) services average 1.33× higher multiples than routine shoppable care (0.9×)
Upper-quartile procedures (Q75 1.18×) jump +19% above the median procedure ratio (Q50 0.99×)
Unnegotiated chargemaster list prices average 9.4× Medicare (14¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

0.9× Medicare

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

Back-Door Captive & ER1.33× Divergence

1.2× Medicare

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

Quantile Tail Spread+19% Upper Tail

Q25 0.74× · Q50 0.99× · Q75 1.18×

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

0.9× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.1× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.5× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.5× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.5× MedicareGood

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

0.5× MedicareGood

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

49% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 73/100Fair

Procedure Prices at Erlanger Bledsoe Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 128 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`	—	$35,244	$30,775	1.1×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$16,865	$19,087	0.9×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$16,207	$19,432	0.8×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$16,160	$17,936	0.9×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$6,707	$8,223	0.8×
C-section delivery (full package) CPT Code: `59510`	$1,343	$3,497	$2,975	unverified
Vaginal delivery (full package) CPT Code: `59400`	$1,227	$3,123	$2,680	unverified
Trauma team activation HCPCS Code: `G0390`	—	$1,383	$1,453	1.0×
Bunion correction surgery CPT Code: `28296`	$394	$991	$3,446	0.3×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$384	$1,013	$6,109	0.2×
Cataract surgery with lens implant CPT Code: `66984`	$394	$842	$2,540	0.3×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$331	$855	$3,372	0.3×
Inguinal hernia repair CPT Code: `49505`	$306	$801	$3,629	0.2×
Total hip replacement CPT Code: `27130`	$802	$802	$13,413	0.1×
Total knee replacement CPT Code: `27447`	$802	$802	$13,523	0.1×
Injection procedure for pain management HCPCS Code: `G0260`	—	$727	$855	0.9×
Sleep study (overnight, in lab) CPT Code: `95810`	$1,929	$736	$1,021	unverified
Breast lump removal CPT Code: `19120`	$263	$704	$3,875	0.2×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,394	$447	$511	0.9×
Colonoscopy with biopsy CPT Code: `45380`	$260	$434	$1,256	0.3×
Blood transfusion CPT Code: `36430`	$399	$399	$498	0.8×
Colonoscopy (diagnostic) CPT Code: `45378`	$134	$362	$981	0.4×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,240	$332	$448	0.7×
Rabies immune globulin HCPCS Code: `90375`	$1,115	$306	$322	1.0×
Upper endoscopy with biopsy CPT Code: `43239`	$220	$329	$987	0.3×
MRI, brain (no contrast) CPT Code: `70551`	$780	$273	$343	0.8×
MRI, knee or other leg joint CPT Code: `73721`	$790	$285	$369	0.8×
CT scan, head (with and without contrast) CPT Code: `70470`	$503	$241	$258	0.9×
MRI, lower back (no contrast) CPT Code: `72148`	$873	$266	$338	0.8×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$318	$235	$272	0.9×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$137	$255	$583	0.4×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,145	$223	$303	0.7×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$139	$217	$148	unverified
CT scan, pelvis CPT Code: `72192`	$463	$184	$163	1.1×
CT scan, chest (no contrast) CPT Code: `71250`	$642	$184	$167	1.1×
CT scan, sinuses CPT Code: `70486`	$533	$178	$166	1.1×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$476	$179	$168	1.1×
CT scan, neck (cervical spine) CPT Code: `72125`	$678	$180	$169	1.1×
CT scan, head (with contrast) CPT Code: `70460`	$435	$203	$242	0.8×
Psychiatric evaluation (first visit) CPT Code: `90791`	$160	$216	$185	unverified
Screening mammogram (both breasts) CPT Code: `77067`	$129	$178	$123	unverified
Psychotherapy session (60 minutes) CPT Code: `90837`	$135	$186	$181	unverified
Care planning with family CPT Code: `90887`	—	$124	$107	1.2×
Hepatitis B immune globulin HCPCS Code: `90371`	$68	$136	$151	0.9×
Psychotherapy session (45 minutes) CPT Code: `90834`	$162	$131	$166	0.8×
Family therapy session CPT Code: `90847`	$68	$151	$173	unverified
New patient office visit (30-44 min) CPT Code: `99203`	$66	$125	$110	1.1×
Ultrasound, abdomen (complete) CPT Code: `76700`	$282	$124	$134	0.9×
CT scan, head (no contrast) CPT Code: `70450`	$371	$146	$160	0.9×
Neurobehavioral status check CPT Code: `96116`	$59	$125	$231	0.5×
Office visit, established patient (30-39 min) CPT Code: `99214`	$66	$138	$123	unverified
Speech therapy (language evaluation) CPT Code: `92507`	$115	$104	$86	1.2×
Office visit, established patient (20-29 min) CPT Code: `99213`	$45	$94	$87	1.1×
Ultrasound, thyroid and neck CPT Code: `76536`	$193	$116	$132	0.9×
Ultrasound, pelvis CPT Code: `76856`	$240	$112	$130	0.9×
Review of medical records for care CPT Code: `90889`	$35	$91	$114	0.8×
Ultrasound, abdomen (limited) CPT Code: `76705`	$173	$100	$126	0.8×
Typhoid vaccine HCPCS Code: `90675`	$161	$359	$347	1.0×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$61	$197	$203	1.0×
Pneumococcal vaccine HCPCS Code: `90732`	$42	$138	$140	1.0×
Drug screening test HCPCS Code: `G0480`	—	$114	$116	1.0×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$36	$105	$111	0.9×
Diagnostic procedure preparation HCPCS Code: `G0279`	—	$56	$35	1.6×
Extended office visit (prolonged) HCPCS Code: `G2212`	$26	$47	$33	1.4×
Orthotic fitting and training CPT Code: `97760`	$31	$65	$51	1.3×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$88	$50	$40	1.3×
Electrical stimulation therapy HCPCS Code: `G0283`	$9	$18	$14	1.3×
Physical therapy (gait training) CPT Code: `97116`	$31	$40	$33	1.2×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$27	$46	$38	1.2×
Prosthetic fitting and training CPT Code: `97761`	$20	$54	$45	1.2×
X-ray, hip CPT Code: `73502`	$26	$49	$93	0.5×
X-ray, lower back CPT Code: `72110`	$29	$54	$112	0.5×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$91	$17	$14	1.2×
Blood test, ferritin (iron stores) CPT Code: `82728`	$141	$17	$14	1.2×
Blood test, vitamin D CPT Code: `82306`	$150	$37	$31	1.2×
Blood test, clotting time (PTT) CPT Code: `85730`	$29	$8	$6	1.3×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$21	$24	$20	1.2×
Speech therapy (group session) CPT Code: `92508`	$14	$32	$27	1.2×
Physical therapy (functional capacity test) CPT Code: `97750`	$20	$45	$38	1.2×
Occupational therapy (self-care training) CPT Code: `97535`	$31	$44	$38	1.2×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$82	$40	$35	1.1×
Physical therapy (manual therapy) CPT Code: `97140`	$31	$37	$34	1.1×
Hepatitis B vaccine HCPCS Code: `90744`	$16	$33	$37	0.9×
Group therapy session CPT Code: `90853`	$16	$37	$100	0.4×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$60	$5	$4	1.3×
Blood test, complete blood count (CBC) CPT Code: `85025`	$49	$10	$8	1.3×
Culture, bacterial CPT Code: `87070`	$37	$11	$9	1.2×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$23	$29	$27	1.1×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$12	$32	$39	0.8×
Psychological testing by technician CPT Code: `96138`	$26	$50	$395	0.1×
Blood test, sodium CPT Code: `84295`	$29	$6	$5	1.2×
Culture, blood CPT Code: `87040`	$44	$13	$11	1.2×
Blood test, thyroid (TSH) CPT Code: `84443`	$109	$21	$18	1.2×
Blood test, PSA (prostate screen) CPT Code: `84153`	$97	$22	$19	1.2×
Hepatitis C antibody test CPT Code: `86803`	$50	$17	$15	1.1×
Blood test, hemoglobin CPT Code: `85018`	$32	$3	$3	1.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$14	$5	$5	1.0×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$10	$24	$25	1.0×
Flu vaccine (high dose) HCPCS Code: `90656`	$8	$20	$25	0.8×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$19	$41	$56	0.7×
X-ray, neck (cervical spine) CPT Code: `72040`	$20	$41	$93	0.4×
X-ray, hand CPT Code: `73130`	$18	$39	$93	0.4×
X-ray, ankle CPT Code: `73610`	$21	$39	$93	0.4×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$97	$12	$11	1.1×
X-ray, shoulder CPT Code: `73030`	$17	$36	$92	0.4×
X-ray, foot CPT Code: `73630`	$17	$36	$92	0.4×
X-ray, chest (two views) CPT Code: `71046`	$18	$34	$93	0.4×
Psychological testing evaluation CPT Code: `96136`	$27	$46	$128	0.4×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$24	$4	$3	1.3×
Blood test, lipase CPT Code: `83690`	$77	$9	$7	1.3×
Blood test, glucose (blood sugar) CPT Code: `82947`	$35	$5	$4	1.3×
Blood test, calcium CPT Code: `82310`	$32	$6	$5	1.2×
Blood test, creatinine (kidney) CPT Code: `82565`	$67	$6	$5	1.2×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$73	$12	$10	1.2×
Blood test, potassium CPT Code: `84132`	$28	$6	$5	1.2×
Blood test, vitamin B12 CPT Code: `82607`	$41	$19	$16	1.2×
Blood test, amylase CPT Code: `82150`	$75	$8	$7	1.1×
Blood test, magnesium CPT Code: `83735`	$35	$8	$7	1.1×
Blood test, basic metabolic panel CPT Code: `80048`	$82	$9	$9	1.0×
Blood test, liver function panel CPT Code: `80076`	$77	$9	$9	1.0×
Flu vaccine injection HCPCS Code: `G0008`	$10	$16	$48	0.3×
X-ray, chest (single view) CPT Code: `71045`	$60	$28	$92	0.3×
Blood antibody screen CPT Code: `86850`	$40	$14	$46	0.3×
X-ray, pelvis CPT Code: `72170`	$16	$32	$110	0.3×
Colorectal cancer screening HCPCS Code: `G0010`	$11	$11	$49	0.2×
Pneumonia vaccine injection HCPCS Code: `G0009`	$10	$10	$49	0.2×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$146	$13	$64	0.2×
Breathing treatment (nebulizer) CPT Code: `94640`	$84	$21	$201	0.1×

Showing top 25 high-impact procedures of 128 total

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

Audit a Bill or Quote at Erlanger Bledsoe Hospital (Zero PHI Required)

CMS CCN: 441306

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $35,244

1. Amount on Your Bill or Quote ($) Pre-filled with Erlanger Bledsoe 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 Erlanger Bledsoe 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 +$53,811 Above Fair BaseRate

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

Your bill ($84,586) is $53,811 above the denoised Fair BaseRate ($30,775) and 3.6× 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) For-Profit / Non-501(c)(3)

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

Public IRS & CMS ownership records classify Erlanger Bledsoe 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

Safety Composite73/100

Would Recommend82%

Rated 9 or 10 (HCAHPS)83%

Median ER Wait97 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Source: CMS Hospital Care Compare (27 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

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

Price Index: 0.75× regional baseline

Quality: 58/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Alliant

+208.9%

Median Household Income$49,655U.S. Census ACS

Local Uninsured Share17.5%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 441306

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 441306) ↗ CMS HCRIS Cost Reports ↗

Published MRF Filebledsoe

Publication / Vintage2026-01-25 · 1098.87 MB

Validated Rate Rows23,392 (CMS v3.0.0)

File Integrity DigestVerified · CCN 441306

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

Erlanger Bledsoe Hospital

Aligned Regional Benchmark Peer

Where They're Good (Patient & Payer Edge)

Where You Can Get Burned (Markup Traps)

REA Pricing Decompiler · 5-Layer Cost-to-Charge Reverse Engineering

Insurer Bargaining Power & Cash-Vulnerability Matrix

Procedure Prices at Erlanger Bledsoe Hospital

Audit a Bill or Quote at Erlanger Bledsoe Hospital (Zero PHI Required)

Above Standard 400% FPL Financial-Assistance Ceiling

Compare Prompt-Pay Cash Rate Against Remaining Deductible

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

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

Clinical Quality, Patient Experience & Infection Benchmarks

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

Notable Payer Contract Outliers (SVD Matrix Anomalies)

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