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Hospital Profile Psychiatric Hospital Government - State 109 Beds · rural Updated: 1/1/2025

Southwestern Virginia Mental Health Institute

340 Bagley Circle, Marion, VA 24354 · 4 Priced Procedures

CMS Overall Rating No CMS Rating
Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Good Deal · Below Fair Market
0.91×vs. Fair Market Price
Position vs. 1.00× Fair Price9% Below Fair Price 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

Typical commercial prices here are 9% below the fair benchmark (0.91×) after accounting for local nurse/doctor wages and patient complexity.

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).66/100 · Caution
66/100Self-Pay Cash Beats Insurance 0% of the Time
File Completeness66Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic100Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment89Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing54Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount6Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.Regional Value Leader
CMS Star RatingNot RatedOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety ScoreNot ScoredComposite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER WaitNo ER DataMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

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

Behavioral Pricing FingerprintLow Shoppable & Low Captive Rates

Uniform Value Leader · Low-Cost Across Departments

Southwestern Virginia Mental Health Institute maintains low, disciplined commercial pricing across both routine shoppable procedures (0.9× Medicare, p50 0.90× Fair BaseRate) and emergency/ancillary services (0.9× Medicare, p75 1.00× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.

#9 of 75 in VA · 10th State Percentile#754 of 3,385 in U.S. · 22nd National Percentile
Advantage

Where They're Good (Patient & Payer Edge)

  • Elective shoppable care is priced 9% below peer Fair BaseRate (0.91×)
  • Self-pay cash beats commercial insurance on 0% of shoppable procedures (25/100 Cash Honesty)
  • CMS clinical safety score (54/100 safety score) with 72% 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
  • Commercial insurance median sits at 0.90× Fair BaseRate (0.9× 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 1.4× Medicare (65¢ 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 & ER1.00× Divergence
0.9× Medicare

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

Quantile Tail Spread+11% Upper Tail
Q25 0.75× · Q50 0.90× · 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
0.9× MedicareGood
Outpatient Surgery & ORBack-Door Captive
1.1× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
1.0× MedicareGood
Back-Door Captive ER VisitsBack-Door Captive
1.3× MedicareGood
Inpatient Lab & PathologyBack-Door Captive
1.2× MedicareGood
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
1.1× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
0% Cash Edge · 25/100Watchout
CMS Clinical Safety & Star ValueIntegrity & Outcomes
3 CMS · 54/100Elevated

Procedure Prices at Southwestern Virginia Mental Health Institute

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 4 published procedures.

Sort:
Audit a Bill & 501(r) Cap ↓
Procedure & Billing Code This Hospital vs. Fair
Psychiatric evaluation (first visit)
CPT Code: 90791
 $210 1.1×
Psychotherapy session (60 minutes)
CPT Code: 90837
 $181 1.0×
Family therapy session
CPT Code: 90847
 $139 0.8×
Psychotherapy session (45 minutes)
CPT Code: 90834
 $124 0.7×
Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at Southwestern Virginia Mental Health Institute (Zero PHI Required)

CMS CCN: 494029
CPT 90791
Fair BaseRate™ $185
Medicare Rate $181
Self-Pay Cash $210
Insurer Median $210
Pre-filled with Southwestern Virginia Mental Health Institute’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
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 Published Cash: $210

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Southwestern Virginia Mental Health Institute's published 45 CFR § 180 self-pay cash rate is $210 (vs. $210 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$25 Above Fair BaseRate

Negotiate Toward $185 Fair BaseRate ($181 Medicare)

Your bill ($210) is $25 above the denoised Fair BaseRate ($185) and 1.2× the $181 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 Southwestern Virginia Mental Health Institute 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 ↑
Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

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

Regional Quality & Price Benchmark

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Southwestern Virginia Mental Health Institute.

Price Index: 0.99× regional baseline
Quality: 54/100 CMS composite
Median Household Income$46,859U.S. Census ACS
Local Uninsured Share5.3%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 66/100 · Caution CMS CCN 494029

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

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 494029) ↗ CMS HCRIS Cost Reports ↗
Published MRF FileCMS_45_CFR_180_FILING.json
Publication / Vintage1/1/2025
Validated Rate Rows4 (CMS v2.0.0)
File Integrity DigestVerified · CCN 494029

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