How many shoppable procedure prices are published for Lake Martin Community Hospital?

Lake Martin Community Hospital in Dadeville, AL currently has 91 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

Hospital Profile Acute Care Hospital Proprietary 46 Beds · rural Updated: 4/1/2026

Lake Martin Community Hospital

201 Mariarden Road, Dadeville, AL 36853 · 91 Priced Procedures · 76% Patient Recommendation

CMS Overall Rating No CMS Rating

Near Fair BaseRate Benchmark

1.00×vs. Fair Market Price

Typical commercial prices here match the fair market benchmark (1.00×) after accounting for local nurse/doctor wages and patient complexity.

20/100 · Quarantined

20/100Self-Pay Cash Beats Insurance 0% of the Time

File Completeness15

Price Logic0

Peer Alignment0

Clean Billing0

Real Cash Discount98

Regional Value Leader

5-Star CMS clinical quality rating paired with 1.00× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Lake Martin Community Hospital prices shoppable and inpatient services (2.3× to 2.3× Medicare, divergence 1.00×) in alignment with regional hospital peers (1.00× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

Regional Benchmark in ALU.S. National Reference Pool

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.78× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 0% of shoppable procedures (98/100 Cash Honesty)
5-Star CMS clinical rating with 76% patient recommendation (81/100 safety score)
Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.7× markup over Medicare rates
Commercial insurance median sits at 1.00× Fair BaseRate (2.3× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 1.28×) jump +28% above the median procedure ratio (Q50 1.00×)
Consolidated metro market (HHI 6,388) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

2.3× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER1.00× Divergence

2.3× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+28% Upper Tail

Q25 0.78× · Q50 1.00× · Q75 1.28×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

2.3× MedicareFair

Outpatient Surgery & ORBack-Door Captive

1.7× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.3× MedicareFair

Back-Door Captive ER VisitsBack-Door Captive

3.3× MedicareElevated

Inpatient Lab & PathologyBack-Door Captive

2.6× MedicareFair

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

1.6× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

0% Cash Edge · 98/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

5 CMS · 81/100Good

Procedure Prices at Lake Martin Community Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 91 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$3,390	$3,390	$19,087	0.2×
Inguinal hernia repair CPT Code: `49505`	$1,239	$1,239	$3,629	0.3×
Sleep study (overnight, in lab) CPT Code: `95810`	$1,052	$1,052	$1,021	1.0×
Colonoscopy with biopsy CPT Code: `45380`	$965	$965	$1,256	0.8×
Bunion correction surgery CPT Code: `28296`	$944	$944	$3,446	0.3×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$803	$803	$448	1.8×
MRI, brain (with and without contrast) CPT Code: `70553`	$634	$634	$511	1.2×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$619	$619	$6,109	0.1×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$496	$496	$8,223	0.1×
MRI, brain (no contrast) CPT Code: `70551`	$388	$388	$343	1.1×
MRI, lower back (no contrast) CPT Code: `72148`	$379	$379	$338	1.1×
MRI, knee or other leg joint CPT Code: `73721`	$397	$397	$369	1.1×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$358	$358	$272	1.3×
CT scan, head (with and without contrast) CPT Code: `70470`	$332	$332	$258	1.3×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$350	$350	$303	1.2×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$363	$363	$583	0.6×
Colonoscopy (diagnostic) CPT Code: `45378`	$341	$341	$981	unverified
Diagnostic mammogram (both breasts) CPT Code: `77066`	$293	$293	$148	2.0×
CT scan, chest (no contrast) CPT Code: `71250`	$276	$276	$167	1.7×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$269	$269	$168	1.6×
CT scan, neck (cervical spine) CPT Code: `72125`	$270	$270	$169	1.6×
CT scan, head (with contrast) CPT Code: `70460`	$284	$284	$242	1.2×
CT scan, pelvis CPT Code: `72192`	$254	$254	$163	1.6×
CT scan, sinuses CPT Code: `70486`	$242	$242	$166	1.5×
Upper endoscopy with biopsy CPT Code: `43239`	$255	$255	$987	0.3×
Ultrasound, abdomen (complete) CPT Code: `76700`	$214	$214	$134	1.6×
Screening mammogram (both breasts) CPT Code: `77067`	$238	$238	$123	unverified
Ultrasound, thyroid and neck CPT Code: `76536`	$199	$199	$132	1.5×
Hepatitis B immune globulin HCPCS Code: `90371`	$224	$224	$151	1.5×
CT scan, head (no contrast) CPT Code: `70450`	$201	$201	$160	1.3×
Ultrasound, abdomen (limited) CPT Code: `76705`	$159	$159	$126	1.3×
Orthotic fitting and training CPT Code: `97760`	$88	$88	$51	1.7×
X-ray, lower back CPT Code: `72110`	$84	$84	$112	0.8×
Typhoid vaccine HCPCS Code: `90675`	$569	$569	$347	1.6×
Drug screening test HCPCS Code: `G0480`	$215	$215	$116	1.9×
Pneumococcal vaccine HCPCS Code: `90732`	$225	$225	$140	1.6×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$146	$146	$56	2.6×
Blood test, vitamin D CPT Code: `82306`	$62	$62	$31	2.0×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$71	$71	$40	1.8×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$64	$64	$38	1.7×
Prosthetic fitting and training CPT Code: `97761`	$75	$75	$45	1.7×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$89	$89	$111	0.8×
Physical therapy (functional capacity test) CPT Code: `97750`	$63	$63	$38	1.7×
Occupational therapy (self-care training) CPT Code: `97535`	$62	$62	$38	1.6×
Blood test, lipase CPT Code: `83690`	$16	$16	$7	2.3×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$41	$41	$35	1.2×
Blood test, creatinine (kidney) CPT Code: `82565`	$10	$10	$5	2.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	$28	$28	$14	2.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$8	$8	$4	2.0×
Blood test, magnesium CPT Code: `83735`	$14	$14	$7	2.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$38	$38	$19	2.0×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$40	$40	$20	2.0×
Blood test, thyroid (TSH) CPT Code: `84443`	$35	$35	$18	1.9×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$8	$8	$4	2.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$12	$12	$6	2.0×
Blood test, vitamin B12 CPT Code: `82607`	$31	$31	$16	1.9×
Physical therapy (gait training) CPT Code: `97116`	$55	$55	$33	1.7×
X-ray, hip CPT Code: `73502`	$78	$78	$93	0.8×
X-ray, neck (cervical spine) CPT Code: `72040`	$66	$66	$93	0.7×
X-ray, hand CPT Code: `73130`	$60	$60	$93	0.6×
X-ray, ankle CPT Code: `73610`	$60	$60	$93	0.6×
X-ray, shoulder CPT Code: `73030`	$57	$57	$92	0.6×
X-ray, foot CPT Code: `73630`	$56	$56	$92	0.6×
X-ray, chest (two views) CPT Code: `71046`	$56	$56	$93	0.6×
Hepatitis C antibody test CPT Code: `86803`	$29	$29	$15	1.9×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$27	$27	$14	1.9×
Physical therapy (manual therapy) CPT Code: `97140`	$51	$51	$34	1.5×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$20	$20	$11	1.8×
X-ray, chest (single view) CPT Code: `71045`	$45	$45	$92	0.5×
X-ray, pelvis CPT Code: `72170`	$49	$49	$110	0.4×
Blood transfusion CPT Code: `36430`	$59	$59	$498	0.1×
Blood test, calcium CPT Code: `82310`	$11	$11	$5	2.2×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$6	$6	$3	2.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$19	$19	$10	1.9×
Culture, bacterial CPT Code: `87070`	$17	$17	$9	1.9×
Blood test, complete blood count (CBC) CPT Code: `85025`	$15	$15	$8	1.9×
Blood test, potassium CPT Code: `84132`	$9	$9	$5	1.8×
Blood test, sodium CPT Code: `84295`	$9	$9	$5	1.8×
Blood test, basic metabolic panel CPT Code: `80048`	$16	$16	$9	1.8×
Culture, blood CPT Code: `87040`	$19	$19	$11	1.7×
Blood test, amylase CPT Code: `82150`	$12	$12	$7	1.7×
Blood test, liver function panel CPT Code: `80076`	$15	$15	$9	1.7×
Blood test, hemoglobin CPT Code: `85018`	$5	$5	$3	1.7×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$8	$8	$5	1.6×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$30	$30	$39	0.8×
Flu vaccine injection HCPCS Code: `G0008`	$29	$29	$48	0.6×
Pneumonia vaccine injection HCPCS Code: `G0009`	$29	$29	$49	0.6×
Blood antibody screen CPT Code: `86850`	$19	$19	$46	0.4×
Hospital observation (per hour) HCPCS Code: `G0378`	$19	$19	$86	0.2×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$14	$14	$64	0.2×
Breathing treatment (nebulizer) CPT Code: `94640`	$30	$30	$201	0.1×

Showing top 25 high-impact procedures of 91 total

Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at Lake Martin Community Hospital (Zero PHI Required)

CMS CCN: 010052

CPT 871

Select Procedure to Audit:

Fair BaseRate™ $19,087

Medicare Rate $14,117

Self-Pay Cash $3,390

Insurer Median $3,390

1. Amount on Your Bill or Quote ($) Pre-filled with Lake Martin Community Hospital’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 274% of 2026 FPL

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.

Step 2 · Cash vs. Insurance Arbitrage Save $1,131 Paying Cash

Self-Pay Cash Rate ($3,390) Beats Your Bill

Lake Martin Community Hospital's published 45 CFR § 180 self-pay cash rate is $3,390 (vs. $3,390 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target Target: $19,087 Fair BaseRate

Negotiate Toward $19,087 Fair BaseRate ($14,117 Medicare)

Your entered amount is at or below the modeled Fair BaseRate benchmark ($19,087).

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) For-Profit / Non-501(c)(3)

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Public IRS & CMS ownership records classify Lake Martin Community 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.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall5/5 Stars (5/5)

Safety Composite81/100

Would Recommend76%

Rated 9 or 10 (HCAHPS)79%

Median ER Wait111 min

Left ER Before Seen0%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Lake Martin Community Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2025-11-21·administrative_or_closure
Closure Notice
Recorded
2025-09-04·cap_corrective_action
CAP Request
Recorded
2025-01-17·administrative_or_closure
Closure Notice
Recorded
2024-12-30·cap_corrective_action
CAP Request
Recorded
2024-10-18·cap_corrective_action
CAP Request
Recorded

Source: CMS Hospital Care Compare (102 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Value & Quality Leader Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Lake Martin Community Hospital.

Price Index: 1.00× regional baseline

Quality: 82/100 CMS composite

Median Household Income$57,185U.S. Census ACS

Local Uninsured Share8.9%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 20/100 · Quarantined CMS CCN 010052

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 010052) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage4/1/2026

Validated Rate Rows0 (CMS v3.0.0)

File Integrity DigestVerified · CCN 010052

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.

Submit MRF Update Correction Policy