Holston Valley Medical Center
130 W. RAVINE RD., KINGSPORT, TN · Balladhealth · · NPI 1487690400
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Ghs o2 uptake rest & indirect CPT 94690 | $41.10 | $274.00 | $15.62 – $134.31 | 18 |
| Ghs ob unlisted IV or art inj or infusion CPT 96379 | $19.35 | $129.00 | $14.89 – $106.61 | 18 |
| Ghs opcc repair cvp without subq port CPT 36575 | $397.80 | $2,652.00 | $595.09 – $1,428.22 | 18 |
| Ghs opcc repair cvp w subq port CPT 36576 | $5,898.00 | $39,320.00 | $924.57 – $3,583.98 | 18 |
| Ghs osteopathic manipulative tx, 1-2 regions CPT 98925 | $5.85 | $39.00 | $11.97 – $44.65 | 18 |
| Ghs osteopathic manipulative tx, 3-4 regions CPT 98926 | $6.45 | $43.00 | $13.20 – $44.65 | 18 |
| Ghs ot dds rom CPT 95851 | $16.80 | $112.00 | $19.36 – $57.70 | 17 |
| Ghs ot prosthetic training/15 min CPT 97761 | $31.95 | $213.00 | $27.14 – $91.51 | 18 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $28.35 | $189.00 | $26.90 – $135.82 | 18 |
| Ghs ot work hardening-additional hours CPT 97546 | $49.95 | $333.00 | $35.08 – $36.83 | 5 |
| Ghs pacing - transcutaneous CPT 92953 | $513.90 | $3,426.00 | $0.88 – $1,504.81 | 18 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $746.55 | $4,977.00 | $955.54 – $1,003.32 | 5 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $142.95 | $953.00 | $80.70 – $1,003.32 | 5 |
| Ghs peritonsillar abscess i andd CPT 42700 | $211.95 | $1,413.00 | $135.79 – $539.25 | 18 |
| Ghs phenylketonurid CPT 84030 | $9.60 | $64.00 | $2.75 – $13.20 | 18 |
| Ghs picc line insert < 5 CPT 36568 | $514.50 | $3,430.00 | $1,474.44 – $3,430.00 | 18 |
| Ghs plngl fx pm cl CPT 26725 | $87.00 | $580.00 | $187.23 – $628.19 | 18 |
| Ghs plt ct-manual CPT 85032 | $7.50 | $50.00 | $2.16 – $10.34 | 18 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | $933.60 | $6,224.00 | $483.68 – $1,955.15 | 18 |
| Ghs ppd (tb intradermal) CPT 86580 | $15.77 | $105.14 | $3.42 – $65.85 | 18 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $16.80 | $112.00 | $4.83 – $23.18 | 18 |
| Ghs protein, misc fluid CPT 84160 | $9.00 | $60.00 | $2.81 – $13.46 | 18 |
| Ghs protoporphyrins fract CPT 84202 | $25.20 | $168.00 | $7.18 – $34.44 | 18 |
| Ghs pr without cont pulse ox CPT 94625 | $35.85 | $239.00 | $34.11 – $134.31 | 18 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | $21.60 | $144.00 | $6.13 – $29.40 | 18 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | $124.95 | $833.00 | $35.08 – $36.83 | 5 |
| Ghs quinidine CPT 80194 | $25.65 | $171.00 | $7.30 – $35.04 | 18 |
| Ghs removal intranasal foreign body CPT 30300 | $59.40 | $396.00 | $28.25 – $302.92 | 18 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $443.25 | $2,955.00 | $342.92 – $3,325.42 | 18 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | $22.50 | $150.00 | $7.95 – $38.14 | 18 |
| Ghs reticulocyte count CPT 85044 | $14.70 | $98.00 | $2.16 – $10.34 | 18 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $20.10 | $134.00 | $6.96 – $33.38 | 18 |
| Ghs sedimentation rate CPT 85651 | $6.30 | $42.00 | $2.14 – $10.25 | 18 |
| Ghs semen analysis fert CPT 89320 | $21.15 | $141.00 | $5.10 – $29.54 | 18 |
| Ghs sensitivity (per antimicro) CPT 87184 | $12.15 | $81.00 | $3.74 – $17.95 | 18 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $296.55 | $1,977.00 | $175.62 – $925.54 | 18 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $247.80 | $1,652.00 | $237.95 – $925.54 | 18 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $181.35 | $1,209.00 | $223.91 – $925.54 | 18 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $283.95 | $1,893.00 | $237.95 – $925.54 | 18 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $136.20 | $908.00 | $150.40 – $456.80 | 18 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $124.20 | $828.00 | $138.76 – $456.80 | 18 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $176.70 | $1,178.00 | $190.33 – $456.80 | 18 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $309.45 | $2,063.00 | $190.33 – $456.80 | 18 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $136.50 | $910.00 | $190.33 – $456.80 | 18 |
| Ghs sleep study unattended CPT 95800 | $184.80 | $1,232.00 | $102.04 – $491.61 | 18 |
| Ghs somatosensory testing lower extremit CPT 95926 | $109.65 | $731.00 | $17.60 – $491.61 | 18 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $272.25 | $1,815.00 | $111.07 – $1,815.00 | 18 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $51.00 | $340.00 | $19.29 – $361.76 | 18 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $107.10 | $714.00 | $44.29 – $234.34 | 18 |
| Ghs st - eval for alt comm CPT 92567 | $17.85 | $119.00 | $18.73 – $85.04 | 18 |
| Ghs strapping shoulder - 29240 CPT 29240 | $51.60 | $344.00 | $31.07 – $302.92 | 18 |
| Ghs st - re-eval for alt comm CPT 92597 | $70.50 | $470.00 | $61.00 – $361.76 | 18 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $323.25 | $2,155.00 | $14.42 – $662.08 | 18 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $77.40 | $516.00 | $75.98 – $484.27 | 18 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $245.85 | $1,639.00 | $72.20 – $1,639.00 | 18 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $222.45 | $1,483.00 | $47.08 – $925.54 | 18 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $242.25 | $1,615.00 | $319.54 – $3,208.77 | 18 |
| Ghs trypsin (fecal) CPT 84488 | $12.75 | $85.00 | $3.65 – $17.52 | 18 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $74.25 | $495.00 | $165.11 – $628.19 | 18 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $377.10 | $2,514.00 | $234.00 – $628.19 | 18 |
| Ghs urine, hydroxproline total CPT 83505 | $42.60 | $284.00 | $12.15 – $58.32 | 18 |
| Ghs urine, porphyrins quant CPT 84120 | $25.80 | $172.00 | $7.36 – $35.30 | 18 |
| Ghs vaginal delivery only CPT 59409 | $464.85 | $3,099.00 | $800.16 – $6,694.57 | 18 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | $556.05 | $3,707.00 | $291.33 – $849.59 | 18 |
| Giardia lamblia antibody CPT 86674 | $25.80 | $172.00 | $7.36 – $35.33 | 18 |
| Gi inhouse confirmation CPT 87045 | $16.50 | $110.00 | $4.72 – $22.66 | 18 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $382.35 | $2,549.00 | $405.00 – $2,064.99 | 18 |
| Glove finger flexion right lg xl HCPCS L3912 | $19.80 | $132.00 | $104.96 – $246.03 | 17 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $247.49 | $1,649.93 | $36.59 – $395.67 | 18 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $364.43 | $2,429.52 | $97.21 – $343.81 | 18 |
| Glucagon plasma - sendout CPT 82943 | $25.05 | $167.00 | $7.15 – $34.30 | 18 |
| Glucose 1 hr post dose CPT 82950 | $8.40 | $56.00 | $2.38 – $11.40 | 18 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | $7.05 | $47.00 | $3.03 – $14.52 | 18 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $4.05 | $27.00 | $1.64 – $7.87 | 18 |
| Glucose blood quantitative CPT 82947 | $6.90 | $46.00 | $1.97 – $9.43 | 18 |
| Glucose body fluid CPT 82945 | $6.90 | $46.00 | $1.97 – $9.43 | 18 |
| Glucose monitoring continual min 72hr pt CPT 95249 | $33.90 | $226.00 | $33.58 – $134.31 | 18 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $17.70 | $118.00 | $6.44 – $30.89 | 18 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $6.90 | $46.00 | $1.96 – $9.41 | 18 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $2,662.54 | $17,750.27 | $11.63 – $1,605.58 | 18 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $32.55 | $217.00 | $9.29 – $44.59 | 18 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $32.40 | $216.00 | $9.26 – $44.45 | 18 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $48.15 | $321.00 | $21.53 – $257.36 | 17 |
| Graft axiofill 1000mg HCPCS J3590 | $94.66 | $631.06 | $42.07 – $298.70 | 17 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $6,208.60 | $41,390.66 | $1.00 – $257.36 | 17 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $26,222.04 | $174,813.58 | $18.94 – $257.36 | 17 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $138.90 | $926.00 | $151.04 – $151.04 | 1 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $316.20 | $2,108.00 | $72.47 – $257.36 | 17 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $1,520.10 | $10,134.00 | $1.00 – $257.36 | 17 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $18,695.80 | $124,638.68 | $118.05 – $283.33 | 17 |
| Great toe with reduction 28495 CPT 28495 | $79.80 | $532.00 | $83.52 – $628.19 | 18 |
| Growth stimulation gene 2 CPT 83006 | $38.40 | $256.00 | $17.96 – $181.44 | 18 |
| G-tube reposition CPT 43761 | $202.20 | $1,348.00 | $237.02 – $568.85 | 18 |
| Gu dilat ureter/urethra s&i CPT 74485 | $796.20 | $5,308.00 | $103.26 – $4,759.31 | 18 |
| Guided cath fluid drainage 10030 CPT 10030 | $517.35 | $3,449.00 | $671.77 – $1,612.25 | 18 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $15,323.15 | $102,154.35 | $7.06 – $23.00 | 2 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $214.65 | $1,431.00 | $28.24 – $28.24 | 1 |
| Guid loc target vol rad tx CPT 77387 | $92.55 | $617.00 | $32.13 – $191.41 | 6 |
| Gw stiffened micro access kit HCPCS C1894 | $3,322.87 | $22,152.46 | $0.31 – $1.00 | 2 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $68.67 | $457.79 | $7.74 – $28.29 | 2 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.