How many shoppable procedure prices are published for Augusta Health?

Augusta Health in Fishersville, VA currently has 117 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Augusta Health's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Augusta Health's median negotiated commercial rate is 0.9× the regionally adjusted fair BaseRate benchmark.

What is Augusta Health's CMS Care Compare overall star rating?

CMS Care Compare assigns Augusta Health an overall hospital quality rating of 4 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 193 Beds · rural Updated: 2026-04-01

Augusta Health

78 Medical Center Drive, Fishersville, VA 22939 · 117 Priced Procedures · 69% Patient Recommendation

CMS Overall Rating 4 / 5 Stars

Good Deal · Below Fair Market

0.94×vs. Fair Market Price

Typical commercial prices here are 6% below the fair benchmark (0.94×) after accounting for local nurse/doctor wages and patient complexity.

84/100 · Corroborated

84/100Self-Pay Cash Beats Insurance 25% of the Time

File Completeness85

Price Logic93

Peer Alignment53

Clean Billing85

Real Cash Discount100

Regional Value Leader

3-Star CMS clinical quality rating paired with 0.94× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Augusta Health prices shoppable and inpatient services (1.1× to 1.0× Medicare, divergence 0.91×) in alignment with regional hospital peers (0.94× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#10 of 75 in VA · 12th State Percentile#952 of 3,385 in U.S. · 28th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 6% below peer Fair BaseRate (0.94×)
Self-pay cash beats commercial insurance on 25% of shoppable procedures (99/100 Cash Honesty)
4-Star CMS clinical rating with 69% patient recommendation (67/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (17.8% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (0.94× 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 0.95× Fair BaseRate (1.1× Medicare), so insured patients should always compare the self-pay cash price before paying.
Specialty infusion drugs (J-codes) average 1.3× Medicare — verify per-unit billing on itemized statements
Consolidated metro market (HHI 8,665) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.1× Medicare

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

Back-Door Captive & ER0.91× Divergence

1.0× Medicare

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

Quantile Tail Spread+5% Upper Tail

Q25 0.82× · Q50 0.95× · Q75 1.00×

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

1.1× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.7× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

0.5× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.6× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.5× MedicareGood

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

1.3× MedicareGood

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

25% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 67/100Fair

Procedure Prices at Augusta Health

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 117 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`	—	$24,673	$30,775	0.8×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$14,836	$19,087	0.8×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$14,732	$19,432	0.8×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$13,465	$17,936	0.8×
Total knee replacement CPT Code: `27447`	—	$13,054	$13,523	1.0×
Total hip replacement CPT Code: `27130`	—	$12,991	$13,413	1.0×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$7,598	$6,109	1.2×
Inguinal hernia repair CPT Code: `49505`	—	$6,203	$3,629	1.7×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$5,954	$8,223	0.7×
Cataract surgery with lens implant CPT Code: `66984`	—	$5,974	$2,540	unverified
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$5,589	$3,372	1.7×
Bunion correction surgery CPT Code: `28296`	—	$4,824	$3,446	1.4×
Breast lump removal CPT Code: `19120`	$7,104	$4,824	$3,875	1.2×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$2,281	$981	2.3×
Upper endoscopy with biopsy CPT Code: `43239`	—	$2,224	$987	unverified
Colonoscopy with biopsy CPT Code: `45380`	—	$1,916	$1,256	1.5×
Blood transfusion CPT Code: `36430`	$722	$1,043	$498	unverified
Injection procedure for pain management HCPCS Code: `G0260`	$1,025	$1,005	$855	1.2×
Sleep study (overnight, in lab) CPT Code: `95810`	$1,447	$865	$1,021	0.8×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$841	$553	$583	0.9×
Rabies immune globulin HCPCS Code: `90375`	$4,931	$472	$322	1.5×
Psychological testing by technician CPT Code: `96138`	—	$454	$395	1.1×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,679	$348	$511	0.7×
MRI, lower back (no contrast) CPT Code: `72148`	$907	$373	$338	unverified
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,358	$343	$448	0.8×
Breathing treatment (nebulizer) CPT Code: `94640`	$118	$222	$201	1.1×
Neurobehavioral status check CPT Code: `96116`	—	$220	$231	1.0×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,103	$222	$303	0.7×
MRI, knee or other leg joint CPT Code: `73721`	$701	$236	$369	0.6×
Psychotherapy session (45 minutes) CPT Code: `90834`	—	$180	$166	1.1×
Family therapy session CPT Code: `90847`	—	$180	$173	1.0×
Psychotherapy session (60 minutes) CPT Code: `90837`	—	$180	$181	1.0×
Psychiatric evaluation (first visit) CPT Code: `90791`	—	$180	$185	1.0×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$394	$203	$272	0.7×
CT scan, head (with contrast) CPT Code: `70460`	$458	$177	$242	0.7×
CT scan, head (with and without contrast) CPT Code: `70470`	$502	$177	$258	0.7×
MRI, brain (no contrast) CPT Code: `70551`	$782	$200	$343	0.6×
Psychological testing evaluation CPT Code: `96136`	—	$135	$128	1.1×
Hepatitis B immune globulin HCPCS Code: `90371`	$563	$140	$151	0.9×
Group therapy session CPT Code: `90853`	—	$103	$100	1.0×
X-ray, pelvis CPT Code: `72170`	$275	$105	$110	1.0×
Ultrasound, abdomen (complete) CPT Code: `76700`	$956	$113	$134	0.8×
Ultrasound, abdomen (limited) CPT Code: `76705`	$860	$106	$126	0.8×
Ultrasound, thyroid and neck CPT Code: `76536`	$462	$105	$132	0.8×
CT scan, chest (no contrast) CPT Code: `71250`	$490	$129	$167	0.8×
CT scan, pelvis CPT Code: `72192`	$548	$116	$163	0.7×
X-ray, chest (single view) CPT Code: `71045`	$159	$88	$92	1.0×
X-ray, foot CPT Code: `73630`	$226	$86	$92	0.9×
X-ray, lower back CPT Code: `72110`	$304	$103	$112	0.9×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$342	$111	$148	0.8×
Screening mammogram (both breasts) CPT Code: `77067`	$292	$91	$123	0.7×
CT scan, sinuses CPT Code: `70486`	$383	$112	$166	0.7×
X-ray, hand CPT Code: `73130`	$226	$85	$93	0.9×
Ultrasound, pelvis CPT Code: `76856`	$734	$106	$130	0.8×
CT scan, head (no contrast) CPT Code: `70450`	$380	$106	$160	0.7×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,913	$110	$168	0.7×
CT scan, neck (cervical spine) CPT Code: `72125`	$807	$110	$169	0.7×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$527	$527	$111	4.7×
Typhoid vaccine HCPCS Code: `90675`	$936	$326	$347	0.9×
Pneumococcal vaccine HCPCS Code: `90732`	$179	$300	$140	2.1×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$139	$175	$56	unverified
X-ray, shoulder CPT Code: `73030`	$226	$77	$92	0.8×
X-ray, hip CPT Code: `73502`	$226	$77	$93	0.8×
X-ray, ankle CPT Code: `73610`	$226	$75	$93	0.8×
Pneumonia vaccine injection HCPCS Code: `G0009`	$51	$48	$49	1.0×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$117	$60	$64	0.9×
Speech therapy (language evaluation) CPT Code: `92507`	$183	$77	$86	0.9×
Flu vaccine (high dose) HCPCS Code: `90656`	$46	$50	$25	2.0×
Flu vaccine injection HCPCS Code: `G0008`	$34	$48	$48	1.0×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	—	$27	$27	1.0×
Colorectal cancer screening HCPCS Code: `G0010`	—	$48	$49	1.0×
Prosthetic fitting and training CPT Code: `97761`	$118	$41	$45	0.9×
Orthotic fitting and training CPT Code: `97760`	$104	$46	$51	0.9×
X-ray, chest (two views) CPT Code: `71046`	$176	$69	$93	0.7×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$52	$36	$40	0.9×
Physical therapy (functional capacity test) CPT Code: `97750`	$68	$34	$38	0.9×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$59	$33	$38	0.9×
Occupational therapy (self-care training) CPT Code: `97535`	$51	$33	$38	0.9×
Drug screening test HCPCS Code: `G0480`	$55	$55	$116	0.5×
X-ray, neck (cervical spine) CPT Code: `72040`	$204	$42	$93	0.5×
Blood antibody screen CPT Code: `86850`	$53	$51	$46	unverified
Physical therapy (therapeutic exercise) CPT Code: `97110`	$64	$39	$35	unverified
Blood test, basic metabolic panel CPT Code: `80048`	$8	$9	$9	1.0×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$9	$11	$11	1.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$9	$3	$3	1.0×
Blood test, amylase CPT Code: `82150`	$33	$7	$7	1.0×
Blood test, calcium CPT Code: `82310`	$5	$5	$5	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$32	$5	$5	1.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	$70	$14	$14	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$11	$10	$10	1.0×
Blood test, lipase CPT Code: `83690`	$14	$7	$7	1.0×
Blood test, magnesium CPT Code: `83735`	$16	$7	$7	1.0×
Hepatitis B vaccine HCPCS Code: `90744`	$32	$32	$37	0.9×
Blood test, potassium CPT Code: `84132`	$4	$5	$5	1.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$62	$19	$19	1.0×
Blood test, sodium CPT Code: `84295`	$5	$5	$5	1.0×
Blood test, vitamin D CPT Code: `82306`	$267	$30	$31	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$5	$4	$4	1.0×
Blood test, vitamin B12 CPT Code: `82607`	$82	$15	$16	0.9×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$29	$13	$14	0.9×
Electrical stimulation therapy HCPCS Code: `G0283`	$78	$13	$14	0.9×
Physical therapy (gait training) CPT Code: `97116`	$66	$30	$33	0.9×
Hospital observation (per hour) HCPCS Code: `G0378`	$50	$50	$86	unverified
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$5	$4	$4	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$20	$6	$6	1.0×
Culture, bacterial CPT Code: `87070`	$72	$9	$9	1.0×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$57	$19	$20	0.9×
Blood test, thyroid (TSH) CPT Code: `84443`	$31	$17	$18	0.9×
Hepatitis C antibody test CPT Code: `86803`	$33	$14	$15	0.9×
Culture, blood CPT Code: `87040`	$12	$10	$11	0.9×
Speech therapy (group session) CPT Code: `92508`	—	$24	$27	0.9×
Physical therapy (manual therapy) CPT Code: `97140`	$77	$28	$34	0.8×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$5	$4	$5	0.8×
Blood test, hemoglobin CPT Code: `85018`	$15	$2	$3	0.7×
Diagnostic procedure preparation HCPCS Code: `G0279`	$128	$13	$35	0.4×
Blood test, liver function panel CPT Code: `80076`	$7	$8	$9	unverified
Blood test, complete blood count (CBC) CPT Code: `85025`	$10	$8	$8	unverified

Showing top 25 high-impact procedures of 117 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 17.8%

Audit a Bill or Quote at Augusta Health (Zero PHI Required)

CMS CCN: 490018

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $24,673

1. Amount on Your Bill or Quote ($) Pre-filled with Augusta Health’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: $10,523 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $10,523

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (17.8% of gross = $10,523).

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

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Augusta Health'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 +$28,440 Above Fair BaseRate

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

Your bill ($59,215) is $28,440 above the denoised Fair BaseRate ($30,775) and 2.5× 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: 262559916

Filing Period: 200903

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 (17.8% 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 Overall3/5 Stars (3/5)

Safety Composite67/100

Would Recommend69%

Rated 9 or 10 (HCAHPS)67%

Median ER Wait185 min

Left ER Before Seen2%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate2.5%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionsame

C. diff Hospital-Onset Infectionbetter

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Augusta Health. Prior administrative notices do not necessarily reflect current compliance status.

2024-06-21·administrative_or_closure
Closure Notice
Recorded
2024-05-16·cap_corrective_action
CAP Request
Recorded
2024-02-09·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (1,005 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 Augusta Health.

Price Index: 1.00× regional baseline

Quality: 61/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Humana

-68.6%

Median Household Income$79,972U.S. Census ACS

Local Uninsured Share7.1%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 84/100 · Corroborated CMS CCN 490018 EIN 262559916

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 490018) ↗ Verify IRS Form 990 (EIN 262559916) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileDownload.aspx

Publication / Vintage2026-04-01 · 28.06 MB

Validated Rate Rows1,430 (CMS v3.0.0)

File Integrity Digestccaa18eb2ea2b34109e5…

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