Ballad Health · Elizabethton, TN
32
In-network payers
544
Disclosed rate categories
121
Beds
4
Care quality
Sycamore Shoals Hospital is a 121-bed voluntary non-profit - private hospital in Elizabethton, TN, affiliated with Ballad Health. Below you'll find publicly disclosed negotiated rates and facility details, including 32 in-network payers and 544 disclosed rate categories.
CCN (Medicare provider number)
440018
NPI
1891801734
Type
Short Term Acute Care Hospital
Ownership
Voluntary Non-Profit - Private
Beds
121
Care Quality
4
Insurance acceptance may vary by specific plan, network status, and services required. Contact your insurance provider or the hospital's billing department to confirm coverage details.
The 24 services Sycamore Shoals Hospital most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data.
Childbirth · Inpatient
MS-DRG 807
$4,348 - $7,965
from 3 insurers · median $7,491
CMS lists this service as CPT 59400, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports obstetrics / child birth services to CMS
Childbirth · Inpatient
MS-DRG 788
$5,455 - $13,991
from 3 insurers · median $10,653
CMS lists this service as CPT 59510, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 788, so these are facility case rates.
Hospital reports obstetrics / child birth services to CMS
Medicine & Surgery · Inpatient
MS-DRG 470
$7,947 - $37,931
from 3 insurers · median $21,431
35 Medicare discharges for this DRG in CMS hospital data
Childbirth · Inpatient
MS-DRG 807
$4,348 - $7,965
from 3 insurers · median $7,491
CMS lists this service as CPT 59610, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports obstetrics / child birth services to CMS
Medicine & Surgery · Inpatient
MS-DRG 743
$5,112 - $13,785
from 3 insurers · median $10,309
Hospital reports inpatient surgical services to CMS
Medicine & Surgery
CPT 29881
$5,364 - $6,374
from 2 insurers · median $5,869
13 Medicare claims in Level 3 Musculoskeletal Procedures (CMS 2024)
Digestive procedures
CPT 43239
$1,978 - $2,016
from 2 insurers · median $1,997
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45385
$314 - $2,272
from 3 insurers · median $2,016
Common here, based on CMS Medicare volume
Digestive procedures
CPT 45380
$2,016 - $2,272
from 2 insurers · median $2,144
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 47562
$8,060 - $10,431
from 2 insurers · median $9,245
Typical for a hospital with this service line
Mammography
CPT 77067
$125 - $188
from 2 insurers · median $156
Common here, based on CMS Medicare volume
Gynecology
CPT 58571
$9,250 - $10,431
from 2 insurers · median $9,840
Typical for a hospital with this service line
Digestive procedures
CPT 45378
$1,978 - $2,016
from 2 insurers · median $1,997
Common here, based on CMS Medicare volume
Gynecology
CPT 58661
$8,825 - $10,431
from 2 insurers · median $9,628
Typical for a hospital with this service line
Medicine & Surgery
CPT 66984
$631 - $4,120
from 3 insurers · median $2,972
Typical for a hospital with this service line
Cardiology and vascular testing
CPT 93306
$235 - $357
from 2 insurers · median $296
Common here, based on CMS Medicare volume
Gynecology
CPT 58662
$8,825 - $10,431
from 2 insurers · median $9,628
Typical for a hospital with this service line
Nuclear imaging
CPT 78452
$441 - $1,020
from 2 insurers · median $731
Common here, based on CMS Medicare volume
Gynecology
CPT 58558
$4,120 - $5,364
from 2 insurers · median $4,742
Typical for a hospital with this service line
CT imaging
CPT 74177
$328
negotiated rate
Common here, based on CMS Medicare volume
Urology
CPT 50590
$5,364 - $10,431
from 2 insurers · median $7,897
Typical for a hospital with this service line
Orthopedics and pain
CPT 29888
$8,825 - $10,431
from 2 insurers · median $9,628
Typical for a hospital with this service line
Orthopedics and pain
CPT 63030
$8,825 - $10,431
from 2 insurers · median $9,628
Typical for a hospital with this service line
Ear, nose and throat
CPT 69436
$2,016 - $2,272
from 2 insurers · median $2,144
Typical for a hospital with this service line
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 20 | 169% | 15 | 2 |
| Insurer B* | 20 | 143% | 9 | 6 |
| Insurer C* | 8 | 77% | 2 | 3 |
| Insurer D* | 6 | 38% | 0 | 6 |
How we chose these services: 2 appear in this hospital's own Medicare claims, 8 are common here based on CMS Medicare volume, and 14 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Sycamore Shoals Hospital.
1501 West Elk Avenue, Elizabethton, TN 37643
(423) 542-1300
The nearest hospitals of similar type and size. Their rates are compared with Sycamore Shoals Hospital for the same insurers and services above.
Watauga Medical Center
▲ Rates typically 64% higher than Sycamore Shoals Hospital (8 services)
Mission Hospital Mcdowell
▼ Rates typically 30% lower than Sycamore Shoals Hospital (20 services)
Caldwell Memorial Hospital
▲ Rates typically 74% higher than Sycamore Shoals Hospital (21 services)
Harlan Arh Hospital
Rates about the same as Sycamore Shoals Hospital (6 services)
Clinch Valley Medical Center
▲ Rates typically 181% higher than Sycamore Shoals Hospital (21 services)
Newport Medical Center
▼ Rates typically 17% lower than Sycamore Shoals Hospital (21 services)
Holston Valley Hosp & Med Ctr
Greenvile Community Hospital West
Franklin Woods Community Hospital
Bristol Regional Medical Center
About Sycamore Shoals Hospital's rates and hospital price transparency.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Sycamore Shoals Hospital range from $328 to $328 across 1 insurers. Aetna's rate is $328. The median at nearby comparable hospitals is $427. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Sycamore Shoals Hospital range from $314 to $2,272 across 3 insurers. UnitedHealthcare's rate is $2,016. The median at nearby comparable hospitals is $1,597. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Vaginal delivery, hospital stay (MS-DRG 807), published negotiated rates at Sycamore Shoals Hospital range from $4,348 to $7,965 across 3 insurers. Cigna's rate is $7,491. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Sycamore Shoals Hospital range from $125 to $188 across 2 insurers. Aetna's rate is $125. The median at nearby comparable hospitals is $226. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Major lower-extremity joint replacement without MCC (MS-DRG 470), published negotiated rates at Sycamore Shoals Hospital range from $7,947 to $37,931 across 3 insurers. Blue Cross Blue Shield's rate is $37,931. The median at nearby comparable hospitals is $20,888. What a patient pays depends on their plan's deductible, coinsurance and network status.
Sycamore Shoals Hospital has 121 beds. Facility type: Short Term Acute Care Hospital.
Sycamore Shoals Hospital is located at 1501 West Elk Avenue, Elizabethton, TN 37643. Its main phone number is (423) 542-1300.
Sycamore Shoals Hospital's CMS Certification Number (CCN), also called its Medicare provider number, is 440018.
The National Provider Identifier (NPI) on file for Sycamore Shoals Hospital is 1891801734.
Sycamore Shoals Hospital is affiliated with Ballad Health.
Sycamore Shoals Hospital lists 32 in-network payers, including Aetna, Ambetter, Ameri Health, Aspirus Health Plan, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
544 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
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The data on this page comes from the files hospitals and payers publish. We help hospitals publish theirs correctly, and take a fresh look at their chargemaster.
We turn your chargemaster and payer contracts into the CMS template file, then keep it current as rates change.
{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers