North Carolina Hospital Pricing Report
April 2026 — 6 findings from 31 hospitals, 49 procedures, 55,238 insurance rates from 271 plans
Atrium Health hospitals (Concord, Charlotte, Shelby, Monroe, etc.) all charge $280 for an MRI Brain without Contrast. Novant Health Thomasville charges $1,946 — the highest in the state. Same CPT code (70551), same procedure, 6.9x price difference.
| Hospital | City | Price |
|---|---|---|
| Atrium Health Pineville | Charlotte | $280 |
| Atrium Health Cleveland | Shelby | $280 |
| Atrium Health Union | Monroe | $280 |
| Atrium Health University City | Charlotte | $280 |
| Atrium Health Lincoln | Lincolnton | $280 |
| Carolinas Medical Center — Northeast | Concord | $280 |
| Duke University Hospital | Durham | $516 |
| Duke Regional Hospital | Durham | $516 |
| Duke Health Raleigh Hospital | Raleigh | $516 |
| Novant Health Forsyth Medical Center | Winston-Salem | $900 |
| Novant Health Presbyterian Medical Center | Charlotte | $900 |
| Novant Health Huntersville Medical Center | Huntersville | $900 |
| Novant Health Matthews Medical Center | Matthews | $900 |
| Novant Health Mint Hill Medical Center | Mint Hill | $900 |
| Novant Health Medical Park Hospital | Winston-Salem | $900 |
| Novant Health Rowan Medical Center | Salisbury | $900 |
| Novant Health Brunswick Medical Center | Bolivia | $900 |
| Novant Health New Hanover Regional Medical Center | Wilmington | $900 |
| J Arthur Dosher Memorial Hospital | Southport | $1,749 |
| Novant Health Thomasville Medical Center | Thomasville | $1,946 |
13,333 of 25,799 insurance rates in North Carolina exceed the cash price. This is dramatically worse than Virginia (19.5%). Patients on high-deductible plans who haven't met their deductible may pay significantly less by asking for the cash rate.
This is not a data error — hospitals publish both rates as required by federal law under the CMS Hospital Price Transparency Rule. It means that for more than half of all insurer-hospital combinations in North Carolina, the negotiated rate is higher than what the hospital would charge a cash-paying patient.
If you're on a high-deductible health plan and haven't met your deductible, always ask the hospital for their cash price before using insurance. In North Carolina, there's a better than even chance it will be lower than your insurer's negotiated rate.
For an MRI Brain without Contrast in the Charlotte metro, Atrium Health charges $280 while Novant Health charges $900 or more. Across all procedures, Atrium Health averages $582 per procedure. Novant Health averages $902. J Arthur Dosher Memorial Hospital in Southport is the most expensive at $2,329 average.
| System | Avg Price | Hospitals | Avg Stars |
|---|---|---|---|
| Atrium Health | $582 | 8 | 3.3 |
| Duke Health | $736 | 3 | 4.0 |
| Novant Health | $902 | 15 | 3.5 |
| Independent (avg) | $1,456 | 5 | — |
| J Arthur Dosher Memorial | $2,329 | 1 | — |
The biggest price variation of any procedure in North Carolina. A Chest X-Ray costs $70 at one hospital and $1,570 at another — a 22.3x difference for the same procedure.
| Procedure | Lowest | Highest | Multiple |
|---|---|---|---|
| Chest X-Ray | $70 | $1,570 | 22.3x |
| CT Abdomen/Pelvis | $351 | $3,384 | 9.6x |
| MRI Lumbar Spine | $270 | $2,353 | 8.7x |
| MRI Cervical Spine | $270 | $2,353 | 8.7x |
| Knee Arthroscopy | $606 | $4,634 | 7.7x |
| CT Chest with Contrast | $233 | $1,719 | 7.4x |
| CT Chest without Contrast | $180 | $1,274 | 7.1x |
| MRI Brain | $280 | $1,946 | 6.9x |
Duke University Hospital in Durham is the only North Carolina hospital in our dataset with a 5-star CMS rating.
4-star hospitals include Novant Health Forsyth (Winston-Salem), Novant Presbyterian (Charlotte), Novant Huntersville, Novant Matthews, Novant Medical Park, Novant Mint Hill, Novant Brunswick, and Atrium Lincoln. Note: Atrium Lincoln is 4-star but penalized by Medicare for hospital-acquired conditions.
Three hospitals have 2-star ratings: Novant Rowan (Salisbury), Atrium Cleveland (Shelby), and Novant New Hanover (Wilmington).
Novant Health Medical Park Hospital (Winston-Salem) has the lowest average price at $118 with a 4-star CMS rating. J Arthur Dosher Memorial Hospital (Southport) has the highest average at $2,329 with no star rating available.
The data shows no correlation between price and quality in North Carolina — patients can find lower prices without sacrificing care quality. The cheapest hospital in the state has a higher CMS rating than many hospitals charging 5-10x more.
Important Context
- Facility fees only. Prices shown are facility fees published by each hospital. Professional fees (radiologist, surgeon, anesthesiologist) are typically billed separately and are not included in the prices shown.
- Insurance rates are not your out-of-pocket cost. Insurance rates shown are the negotiated amount between the hospital and insurer. Your actual cost depends on your deductible status, copay percentage, and coinsurance terms.
- Inpatient vs outpatient. Imaging, lab, and screening prices are outpatient. Surgical procedure prices (hip replacement, hernia repair, cholecystectomy) may reflect inpatient facility fees including the hospital stay.
- Financial data timing. Charity care amounts and executive compensation reflect the most recent IRS 990 and CMS Cost Report filings, which may be from 1-2 fiscal years prior. Hospital prices are from files downloaded April 2026.
- Financial assistance requires application. Eligibility thresholds shown are from each system's published Financial Assistance Policy. Patients must apply and provide income documentation. Asset limits may apply. Thresholds may change — always confirm directly with the hospital.
- Quality vs price correlation. The finding that cheaper hospitals have higher ratings on average is a correlation across North Carolina hospitals. It does not mean every cheap hospital is high quality. Individual hospital quality should be evaluated independently.
Data Sources & Methodology
Every number traces to a verified federal source. All comparisons use the same CPT/HCPCS procedure code across hospitals. 17 data sources merged on CMS Certification Number (CCN) — the unique 6-digit identifier assigned to every Medicare-participating hospital.
Price data: Hospital Machine-Readable Files (45 CFR Part 180) — downloaded directly from each hospital's website, April 2026.
Quality data: CMS Hospital Compare (star ratings), HCAHPS Patient Satisfaction Survey, CMS Timely & Effective Care, CMS Complications & Deaths, CMS Unplanned Hospital Visits.
Safety data: CMS Healthcare-Associated Infections (MRSA, C.diff, CLABSI), CMS Hospital-Acquired Condition Reduction Program (penalties), CMS Value-Based Purchasing (quality scores), Medicare Spending Per Beneficiary.
Financial data: CMS Cost Reports (charity care, revenue, net income), IRS 990 filings via ProPublica Nonprofit Explorer (officer compensation), Hospital Financial Assistance Policies (ACA Section 501(r)).
Additional: Medicare Inpatient Utilization, CMS ASC Quality Reporting, CMS ASC Payment Rates (Addendum AA/BB).
We do not estimate prices. Every price is a price a hospital published. Every quality score is a score CMS calculated.
Compare North Carolina hospital prices at hospitalcost.com
Contact: richard@hospitalcost.com
This report is for consumer education purposes only. It is not medical advice. Actual costs depend on your insurance plan, deductible status, clinical circumstances, and negotiated rates. HospitalCost is not affiliated with any hospital, health system, insurance company, or government agency. Published April 2026.