Athens Limestone Hospital
700 West Market Street, Athens, AL 35611 · 92 Priced Procedures · 74% Patient Recommendation
Typical commercial prices here are 12% below the fair benchmark (0.88×) after accounting for local nurse/doctor wages and patient complexity.
4-Star CMS clinical quality rating paired with 0.88× fair market pricing.
Uniform Value Leader · Low-Cost Across Departments
Athens Limestone Hospital maintains low, disciplined commercial pricing across both routine shoppable procedures (1.0× Medicare, p50 0.87× Fair BaseRate) and emergency/ancillary services (1.0× Medicare, p75 0.98× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.
Where They're Good (Patient & Payer Edge)
- Elective shoppable care is priced 12% below peer Fair BaseRate (0.88×)
- Self-pay cash beats commercial insurance on 10% of shoppable procedures (25/100 Cash Honesty)
- 2-Star CMS clinical rating with 74% patient recommendation (73/100 safety score)
- Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.2× markup over Medicare rates
- Commercial insurance median sits at 0.87× Fair BaseRate (1.0× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Even at low-cost facilities (0.88× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
- Consolidated metro market (HHI 6,582) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Athens Limestone Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 92 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Sleep study (overnight, in lab) CPT Code: 95810 | $778 | 0.8× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $510 | 0.9× |
| Blood transfusion CPT Code: 36430 | $412 | 0.8× |
| MRI, knee or other leg joint CPT Code: 73721 | $347 | 0.9× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $337 | 0.8× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $323 | 0.6× |
| Rabies immune globulin HCPCS Code: 90375 | $288 | 0.9× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $221 | 0.8× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $221 | 0.7× |
| MRI, lower back (no contrast) CPT Code: 72148 | $222 | 0.7× |
| MRI, brain (no contrast) CPT Code: 70551 | $216 | 0.6× |
| New patient office visit (30-44 min) CPT Code: 99203 | $149 | 1.4× |
| CT scan, head (with contrast) CPT Code: 70460 | $169 | 0.7× |
| Hepatitis B immune globulin HCPCS Code: 90371 | $142 | 0.9× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $164 | 0.6× |
| Occupational therapy (therapeutic activities) CPT Code: 97530 | $83 | 2.1× |
| Office visit, established patient (20-29 min) CPT Code: 99213 | $100 | 1.1× |
| Office visit, established patient (30-39 min) CPT Code: 99214 | $108 | 0.9× |
| X-ray, hand CPT Code: 73130 | $81 | 0.9× |
| X-ray, hip CPT Code: 73502 | $81 | 0.9× |
| X-ray, ankle CPT Code: 73610 | $81 | 0.9× |
| X-ray, shoulder CPT Code: 73030 | $80 | 0.9× |
| X-ray, foot CPT Code: 73630 | $80 | 0.9× |
| Ultrasound, abdomen (limited) CPT Code: 76705 | $98 | 0.8× |
| Ultrasound, pelvis CPT Code: 76856 | $97 | 0.7× |
Audit a Bill or Quote at Athens Limestone Hospital (Zero PHI Required)
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.
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Athens Limestone Hospital's published 45 CFR § 180 self-pay cash rate is $4,629 (vs. $778 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $1,021 Fair BaseRate ($877 Medicare)
Your bill ($4,629) is $3,608 above the denoised Fair BaseRate ($1,021) and 5.3× the $877 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Public IRS & CMS ownership records classify Athens Limestone 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.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Athens Limestone Hospital. Prior administrative notices do not necessarily reflect current compliance status.
- 2025-02-12·administrative_or_closure
Closure Notice
Recorded - 2024-11-06·warning_notice
Warning Notice
Recorded
Source: CMS Hospital Care Compare (421 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Athens Limestone Hospital.
Notable Payer Contract Outliers (SVD Matrix Anomalies)
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
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.