Lee County Community Hospital
127 Health Care Drive, Pennington Gap, VA 24277 · 95 Priced Procedures · 88% Patient Recommendation
Typical commercial prices here are +58% above the fair benchmark (1.58×) even after accounting for local nurse/doctor wages and patient complexity.
5-Star CMS clinical quality rating paired with 1.58× fair market pricing.
Wide Procedure Spread · Upper-Quartile Skew Pricer
Lee County Community Hospital prices routine shoppable procedures at 2.3× Medicare (median 1.34× Fair BaseRate) while upper-quartile commercial rates jump +63% to 2.18× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 1.05× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 70% of shoppable procedures (99/100 Cash Honesty)
- 5-Star CMS clinical rating with 88% patient recommendation (83/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (23.1% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (1.58× 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 1.34× Fair BaseRate (2.3× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 2.18×) jump +63% above the median procedure ratio (Q50 1.34×)
- Unnegotiated chargemaster list prices average 6.8× Medicare (16¢ true HCRIS cost per $1 gross)
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 Lee County Community Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 95 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Rabies immune globulin HCPCS Code: 90375 | $3,423 | 10.6× |
| Colonoscopy with biopsy CPT Code: 45380 | $1,888 | unverified |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $1,682 | unverified |
| Upper endoscopy with biopsy CPT Code: 43239 | $1,641 | unverified |
| Hepatitis B immune globulin HCPCS Code: 90371 | $1,569 | unverified |
| MRI, brain (with and without contrast) CPT Code: 70553 | $1,162 | 2.3× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $840 | 1.9× |
| MRI, knee or other leg joint CPT Code: 73721 | $854 | unverified |
| MRI, lower back (no contrast) CPT Code: 72148 | $762 | 2.3× |
| MRI, brain (no contrast) CPT Code: 70551 | $760 | 2.2× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $735 | unverified |
| Psychological testing by technician CPT Code: 96138 | $698 | unverified |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $670 | 2.2× |
| CT scan, head (with contrast) CPT Code: 70460 | $606 | 2.5× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $606 | 2.3× |
| Neurobehavioral status check CPT Code: 96116 | $548 | unverified |
| Blood transfusion CPT Code: 36430 | $509 | 1.0× |
| CT scan, head (no contrast) CPT Code: 70450 | $505 | unverified |
| CT scan, pelvis CPT Code: 72192 | $364 | 2.2× |
| CT scan, chest (no contrast) CPT Code: 71250 | $366 | 2.2× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $367 | 2.2× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $367 | 2.2× |
| CT scan, sinuses CPT Code: 70486 | $348 | 2.1× |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $317 | unverified |
| Ultrasound, pelvis CPT Code: 76856 | $317 | unverified |
Audit a Bill or Quote at Lee County Community Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $3,438
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (23.1% of gross = $3,438).
Self-Pay Cash Rate ($3,423) Beats Your Bill
Lee County Community Hospital's published 45 CFR § 180 self-pay cash rate is $3,423 (vs. $3,423 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $322 Fair BaseRate ($275 Medicare)
Your bill ($14,883) is $14,561 above the denoised Fair BaseRate ($322) and 54.1× the $275 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (23.1% 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
Source: CMS Hospital Care Compare (114 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 Lee County Community Hospital.
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.