Important information about price comparisons and estimates
Ballad Health values transparency in healthcare, and ensuring patients have the tools to manage the cost of healthcare. Unlike many other competing providers of outpatient services in the region served by Ballad Health, it is the policy of Ballad Health to not only provide pricing transparently where possible, but to also provide significant discounts – or even writing off the entire cost of services provided – for patients who are low income and who qualify for these programs.
In 2019, Ballad Health provided healthcare services costing more than $60 million, the cost of which was written off as charity care for low-income patients, and over the last five years that total exceeded $300 million. Additionally, Ballad Health incurs costs of several million dollars annually for the provision of 24-hour per day coverage for emergency diagnostics and services – costs which are not incurred by many other competing providers of outpatient services in the region and which are not reimbursed directly to Ballad Health.
The pricing agreements between insurers and Ballad Health are complex and attempt to reflect the actual cost to the hospitals of the delivery of healthcare services. Many of the costs associated with hospital services are not shared by competing providers of outpatient services, and thus the pricing negotiated with the insurers may vary widely from pricing with non-hospital outpatient services.
Price estimator tool
The Ballad Health price estimator tool is intended to provide you with a good faith estimate of your out-of-pocket costs.
These estimates include hospital items and services associated with a procedure such as medical services, room and board, and supplies. This estimate is a best effort based on the information we have available at the time of the request.
This estimate is not a guarantee of what you will be charged. The final charges may vary depending upon the actual services you receive, equipment and medications necessary for treatment and other variables which are not possible to know in advance of the hospitalization or service. The estimate may vary based on your medical benefits or eligibility for the hospital’s program for discounts or free care.
Launch the Price Estimator
For additional information about our price estimate tool and how it works, please read our frequently asked questions (FAQs) below or call us at (423) 431-1776.
Ballad Health standard charges
These machine-readable files provide a listing of all charges each hospital facility may bill for inpatient and outpatient services. The files also include payer-specific negotiated payment rates and the minimum and maximum payment rate for each item. Some items are bundled with other services and may not identify a specific payment rate.
The actual cost of your service will vary based on factors specific to your case, such as your length of stay in the hospital or the complexity of your medical condition.
Please see the following links to view the list of standard charges for your hospital or call (423) 431-1776 should you have questions.
Bristol Regional Medical Center [TXT file, 225.5 MB]
Dickenson Community Hospital [TXT file, 18.3 MB]
Franklin Woods Community Hospital [TXT file, 60.1 MB]
Greeneville Community Hospital [TXT file, 148.7 MB]
Hancock County Hospital [TXT file, 28.5 MB]
Hawkins County Memorial Hospital [TXT file, 85.3 MB]
Holston Valley Medical Center [TXT file, 229.7 MB]
Indian Path Community Hospital [TXT file, 63.3 MB]
Johnson City Medical Center, Niswonger Children's Hospital and Woodridge Hospital [TXT file, 166.4 MB]
Johnson County Community Hospital [TXT file, 20.6 MB]
Johnston Memorial Hospital [TXT file, 86.9 MB]
Lonesome Pine Hospital and Norton Community Hospital [TXT file, 85.3 MB]
Russell County Hospital [TXT file, 37.6 MB]
Smyth County Community Hospital [TXT file, 41.4 MB]
Sycamore Shoals Hospital [TXT file, 53.5 MB]
Unicoi County Hospital [TXT file, 32.9 MB]
Standard charges files last updated Feb. 23, 2021.
Frequently asked questions
- Q. What is a shoppable service?
Our Price Estimate Tool provides estimates for 300 shoppable services. These are services that can be scheduled in advance such as joint replacements, mammogram screenings and physical therapy.
- Q. Are medications considered shoppable services?
Hospital administration of a medication could be considered a shoppable service if it can be scheduled in advance. Examples include administration of flu shots or medication infusions for chronic conditions such as cancer treatments.
- Q. What is a good-faith estimate?
A good-faith estimate is a projection of cost based on the information given at the time of the estimate. It is not a guarantee of final cost, and could be higher or lower depending on several factors such as insurance coverage, a change in services required at the time of service, and additional fees.
- Q. How do I get an estimate for a hospital procedure or service?
There are two ways to obtain an estimate. One is obtaining the estimate yourself online. If you have the Ballad Health app and MyChart, you can log in to your account and choose Estimate My Bill. You may also obtain an estimate from our Ballad Health website or through your MyChart account by choosing Get an Estimate.
- Q. What goes into my cost estimate?
Estimates include hospital items and services associated with a procedure cost, such as supplies, procedures, room and board and facility fees. At the time of registration for your scheduled visit, our team will provide an estimate based on the CPT Code(s) provided by your healthcare professional and your medical coverage.
- Q. What is a CPT Code?
Current Procedural Terminology (CPT) codes are an important part of the medical billing process and are a universal way to identify medical procedures. Each procedure is given its own unique five-digit code that health insurance companies use to identify what type of care was provided. If you are unsure about what code to use for your estimate, check with your provider.
- Q. What types of services are not included in an estimate?
Generally, costs that are not included in the estimate are office visits before or after your procedure or other professional fees for physician services (i.e. surgeon, radiologist, anesthesiologist, pathologist, etc.). These are usually billed separately by the provider.
- Q. Are preventive care services included in estimates?
Under the Affordable Care Act, most insurance plans cover what are called “preventive services.” These include screenings for mammograms, cholesterol, lung cancer, and other preventive services your plan considers to be in-network. Currently, our estimate tool may show an out-of-pocket cost for covered preventive services, resulting in an inaccurate estimate. Please call (423) 431-1776 to get the most accurate estimate for preventive services.
- Q. Is the estimate a guarantee of what I will be expected to pay?
The tool provides a good-faith estimate of your out-of-pocket healthcare need, but you should not rely on this estimate as a guarantee of your final cost. We try our best to give you an accurate assessment of charges, but estimates may be higher or lower than your final cost depending on many factors.
- Q. Why would a final cost vary from the estimate?
Actual expenses may vary from patient to patient depending upon your physician’s treatment choices, your particular healthcare needs or whether you qualify for discounts or financial assistance. Your final bill could also change if your provider determines you need additional services during a procedure that weren’t included in your pre-service estimate. Likewise, costs may vary based on the information you enter into the estimate tool or your medical benefits and eligibility. Please check with your insurance provider if you need help understanding your benefits or the service you’ve chosen.
- Q. Will my estimate include any discounts for my health insurance?
When requesting an estimate, make sure you have your current health insurance on file. Estimates may change as a result of your medical benefits and eligibility. For example, the cost of care could differ from your estimate if your insurance provider considers the service out-of-network or not medically necessary. Your final cost could also change if you have met all or part of your deductible or maximum out-of-pocket expenses at the time of treatment.
- Q. What is a deductible?
In a health insurance plan, your deductible is the amount of money you need to spend out of pocket for most eligible medical services or medications before your health insurance starts covering your healthcare costs. With a $3,000 deductible, for example, you pay the first $3,000 of covered services yourself.
- Q. What is maximum out-of-pocket expenses?
Your out-of-pocket maximum is the most you'll have to pay for covered healthcare services in a year if you have health insurance. Deductibles, copayments, and coinsurance count toward your out-of-pocket maximum. However, monthly premiums do not.
- Q. Where do I call for additional questions about my estimate?
For questions regarding your estimate, please call (423) 431-1776.
- Q. What is the difference between the machine readable standard charges file and the basic standard charges file?
The machine readable file provides a listing of all items and services, including DRG’s and service packages, along with payor rates and cash pay pricing. The basic standard charges file provides a listing of all items and services along with the current fee charged in an easy to search format.
- Q. Where do I call for additional questions about my bill?
For questions regarding your bill, please call (423) 408-7400.
- Q. Where do I find pricing about Ballad Health's group health plan?
The Transparency in Coverage Final Rule requires group health plans provide machine-readable files for commercial price information. Group health plans must make certain that healthcare price information is publicly available in downloadable machine-readable files beginning July 1, 2022. Machine-readable files are available to be sure Ballad Health's group health plan is compliant with the requirement to include in-network negotiated rates and historical payments to out-of-network providers and their billed charges. You can access the files by clicking this link.