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Hospital Profile Psychiatric Hospital Voluntary non-profit - Private 115 Beds · urban Updated: 2026-06-30

Highland Hospital

300 56Th Street, Se, Charleston, WV 25304 · 2 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.High Markup · Shop Alternatives
2.02×vs. Fair Market Price
Position vs. 1.00× Fair Price+102% Above 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 +102% above the fair benchmark (2.02×) even 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).60/100 · Caution
60/100Self-Pay Cash Beats Insurance 7% of the Time
File Completeness85Provenance (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 Logic4Coherence (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 Alignment65Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing64Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount100Cash 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.High-Markup · Check Safety
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 FingerprintHigh-HHI Market Leverage

Consolidated System Premium Pricer

Operating in a concentrated regional market (CBSA HHI 6,304), Highland Hospital commands a 2.02× BaseRate commercial premium across insurers. Self-pay cash quotes, in-state peer hospitals, and freestanding outpatient facilities offer critical leverage against consolidated system pricing.

#26 of 28 in WV · 89th State Percentile#3,088 of 3,385 in U.S. · 91st National Percentile
Advantage

Where They're Good (Patient & Payer Edge)

  • Bottom-quartile procedures (Q25) price at 1.97× the peer BaseRate benchmark
  • Self-pay cash beats commercial insurance on 7% of shoppable procedures (99/100 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 2.6× markup over Medicare rates
  • Commercial insurance median sits at 2.09× Fair BaseRate (2.1× Medicare), so insured patients should always compare the self-pay cash price before paying.
  • Specialty infusion drugs (J-codes) average 2.4× Medicare — verify per-unit billing on itemized statements
  • Consolidated metro market (HHI 6,304) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Front-Door ShoppableElective / Imaging
2.1× Medicare

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

Back-Door Captive & ER1.00× Divergence
2.1× Medicare

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

Quantile Tail Spread+-6% Upper Tail
Q25 1.97× · Q50 2.09× · Q75 1.97×

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
2.1× MedicareGood
Outpatient Surgery & ORBack-Door Captive
2.6× MedicareFair
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
2.3× MedicareFair
Back-Door Captive ER VisitsBack-Door Captive
3.0× MedicareFair
Inpatient Lab & PathologyBack-Door Captive
2.8× MedicareFair
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
2.4× MedicareFair
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
7% Cash Edge · 99/100Good
CMS Clinical Safety & Star ValueIntegrity & Outcomes
3 CMS · 54/100Elevated

Procedure Prices at Highland Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 2 published procedures.

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Audit a Bill & 501(r) Cap ↓
Procedure & Billing Code This Hospital vs. Fair
Residential mental health treatment
HCPCS Code: H2036
 $800 unverified
Group therapy session
CPT Code: 90853
 $221 unverified
Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

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

CMS CCN: 514001
CPT H2036
Fair BaseRate™ $406
Medicare Rate $235
Self-Pay Cash $1,141
Insurer Median $800
Pre-filled with Highland Hospital’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 Save $2,559 Paying Cash

Self-Pay Cash Rate ($1,141) Beats Your Bill

Highland Hospital's published 45 CFR § 180 self-pay cash rate is $1,141 (vs. $800 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$3,294 Above Fair BaseRate

Negotiate Toward $406 Fair BaseRate ($235 Medicare)

Your bill ($3,700) is $3,294 above the denoised Fair BaseRate ($406) and 15.7× the $235 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)

EIN: 851266867

Public IRS & CMS ownership records classify Highland 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

CMS Price Transparency Administrative Enforcement Log

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

  • 2026-05-19·cap_corrective_action

    CAP Request

    Recorded
  • 2026-02-17·warning_notice

    Warning Notice

    Recorded
  • 2024-12-20·administrative_or_closure

    Closure Notice

    Recorded
  • 2024-10-03·cap_corrective_action

    CAP Request

    Recorded

Source: CMS Hospital Care Compare. 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

Higher-Quality, Above-Median Price Tier

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

Price Index: 1.81× regional baseline
Quality: 54/100 CMS composite
Median Household Income$58,887U.S. Census ACS
Local Uninsured Share4.7%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 60/100 · Caution CMS CCN 514001 EIN 851266867

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 514001) ↗ Verify IRS Form 990 (EIN 851266867) ↗ CMS HCRIS Cost Reports ↗
Published MRF File851266867_summit-bhc-west-virginia-llc_standardcharges.json
Publication / Vintage2026-06-30 · 0.14 MB
Validated Rate Rows27 (CMS v3.0.0)
File Integrity Digestc0527bcfbb246a88a49e…

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