Wellmont Holston Valley Medical Center
130 West Ravine Road, Kingsport, TN 37662 · 103 Priced Procedures · 57% Patient Recommendation
Typical commercial prices here are 5% below the fair benchmark (0.95×) after accounting for local nurse/doctor wages and patient complexity.
3-Star CMS clinical quality rating paired with 0.95× fair market pricing.
Aligned Regional Benchmark Peer
Wellmont Holston Valley Medical Center prices shoppable and inpatient services (1.1× to 1.0× Medicare, divergence 0.91×) in alignment with regional hospital peers (0.95× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.
Where They're Good (Patient & Payer Edge)
- Elective shoppable care is priced 5% below peer Fair BaseRate (0.95×)
- Self-pay cash beats commercial insurance on 66% of shoppable procedures (99/100 Cash Honesty)
- 2-Star CMS clinical rating with 57% patient recommendation (62/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (17.9% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (0.95× 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 0.93× Fair BaseRate (1.1× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Specialty infusion drugs (J-codes) average 1.9× Medicare — verify per-unit billing on itemized statements
- Consolidated metro market (HHI 5,439) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Wellmont Holston Valley Medical Center
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 103 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Trauma team activation HCPCS Code: G0390 | $2,078 | 1.4× |
| Colonoscopy with biopsy CPT Code: 45380 | $1,192 | 0.9× |
| Upper endoscopy with biopsy CPT Code: 43239 | $903 | 0.9× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $855 | 0.8× |
| Injection procedure for pain management HCPCS Code: G0260 | $757 | 0.9× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $544 | 0.9× |
| MRI, knee or other leg joint CPT Code: 73721 | $499 | 1.4× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $523 | 1.0× |
| Blood transfusion CPT Code: 36430 | $439 | 0.9× |
| Psychological testing by technician CPT Code: 96138 | $408 | 1.0× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $376 | 0.8× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $312 | 1.0× |
| MRI, lower back (no contrast) CPT Code: 72148 | $311 | 0.9× |
| Rabies immune globulin HCPCS Code: 90375 | $294 | 0.9× |
| MRI, brain (no contrast) CPT Code: 70551 | $311 | 0.9× |
| CT scan, head (with contrast) CPT Code: 70460 | $334 | unverified |
| CT scan, head (with and without contrast) CPT Code: 70470 | $352 | unverified |
| Neurobehavioral status check CPT Code: 96116 | $213 | 0.9× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $235 | 0.9× |
| Breathing treatment (nebulizer) CPT Code: 94640 | $208 | 1.0× |
| CT scan, head (no contrast) CPT Code: 70450 | $210 | unverified |
| Family therapy session CPT Code: 90847 | $177 | 1.0× |
| Psychotherapy session (60 minutes) CPT Code: 90837 | $177 | 1.0× |
| Psychotherapy session (45 minutes) CPT Code: 90834 | $177 | unverified |
| Hepatitis B immune globulin HCPCS Code: 90371 | $145 | 1.0× |
Audit a Bill or Quote at Wellmont Holston Valley Medical Center (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $1,150
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (17.9% of gross = $1,150).
Self-Pay Cash Rate ($965) Beats Your Bill
Wellmont Holston Valley Medical Center's published 45 CFR § 180 self-pay cash rate is $965 (vs. $2,078 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $1,453 Fair BaseRate ($1,362 Medicare)
Your bill ($6,434) is $4,981 above the denoised Fair BaseRate ($1,453) and 4.7× the $1,362 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (17.9% 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.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)Source: CMS Hospital Care Compare (1,220 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Wellmont Holston Valley Medical Center.
Notable Payer Contract Outliers (SVD Matrix Anomalies)
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
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.