How many shoppable procedure prices are published for Atrium Health Navicent Rehabilitation Hopsital?

Atrium Health Navicent Rehabilitation Hopsital in Macon, GA currently has 132 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Atrium Health Navicent Rehabilitation Hopsital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Atrium Health Navicent Rehabilitation Hopsital's median negotiated commercial rate is 0.9× the regionally adjusted fair BaseRate benchmark.

Hospital Profile General Acute Care Hospital Updated: 2025-11-19

Atrium Health Navicent Rehabilitation Hopsital

3351 Northside Dr, Macon, GA 31210 · 132 Priced Procedures

CMS Overall Rating No CMS Rating

Good Deal · Below Fair Market

0.90×vs. Fair Market Price

Typical commercial prices here are 10% below the fair benchmark (0.90×) after accounting for local nurse/doctor wages and patient complexity.

84/100 · Corroborated

84/100Self-Pay Cash Beats Insurance 52% of the Time

File Completeness66

Price Logic98

Peer Alignment66

Clean Billing91

Real Cash Discount100

Regional Value Leader

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Atrium Health Navicent Rehabilitation Hopsital prices routine shoppable procedures near 0.8× Medicare (p50 0.86×) while skewing captive emergency, lab, and upper-quartile codes to 1.3× Medicare (p75 1.11×, +29% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#20 of 100 in GA · 19th State Percentile#621 of 3,385 in U.S. · 18th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 10% below peer Fair BaseRate (0.90×)
Self-pay cash beats commercial insurance on 52% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (54/100 safety score) with 72% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (28.2% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (0.90× 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.
Captive ER (1.2×) & laboratory (2.6×) services average 1.63× higher multiples than routine shoppable care (0.8×)
Upper-quartile procedures (Q75 1.11×) jump +29% above the median procedure ratio (Q50 0.86×)
Unnegotiated chargemaster list prices average 10.8× Medicare (14¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

0.8× Medicare

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

Back-Door Captive & ER1.63× Divergence

1.3× Medicare

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

Quantile Tail Spread+29% Upper Tail

Q25 0.62× · Q50 0.86× · Q75 1.11×

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

0.8× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.0× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.0× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.2× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

2.6× MedicareFair

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

2.0× MedicareGood

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

52% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 54/100Elevated

Procedure Prices at Atrium Health Navicent Rehabilitation Hopsital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 132 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	—	$36,014	$30,775	1.2×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$22,898	$19,087	1.2×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$22,004	$19,432	1.1×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$21,113	$17,936	1.2×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$9,106	$8,223	1.1×
Total hip replacement CPT Code: `27130`	—	$4,547	$13,413	0.3×
Total knee replacement CPT Code: `27447`	—	$4,475	$13,523	0.3×
C-section delivery (full package) CPT Code: `59510`	—	$2,613	$2,975	0.9×
Vaginal delivery (full package) CPT Code: `59400`	—	$2,379	$2,680	0.9×
Cataract surgery with lens implant CPT Code: `66984`	—	$2,251	$2,540	0.9×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$2,187	$3,372	0.6×
Bunion correction surgery CPT Code: `28296`	—	$1,959	$3,446	0.6×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$1,480	$6,109	0.2×
Trauma team activation HCPCS Code: `G0390`	—	$1,323	$1,453	0.9×
Inguinal hernia repair CPT Code: `49505`	—	$1,198	$3,629	0.3×
Breast lump removal CPT Code: `19120`	—	$1,000	$3,875	0.3×
Injection procedure for pain management HCPCS Code: `G0260`	—	$960	$855	1.1×
Colonoscopy with biopsy CPT Code: `45380`	—	$938	$1,256	0.7×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$656	$981	0.7×
Upper endoscopy with biopsy CPT Code: `43239`	—	$652	$987	0.7×
Sleep study (overnight, in lab) CPT Code: `95810`	—	$554	$1,021	0.5×
MRI, brain (with and without contrast) CPT Code: `70553`	—	$357	$511	0.7×
Rabies immune globulin HCPCS Code: `90375`	$7,440	$285	$322	0.9×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	—	$270	$448	0.6×
Neurobehavioral status check CPT Code: `96116`	—	$213	$231	0.9×
MRI, brain (no contrast) CPT Code: `70551`	—	$224	$343	0.7×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$572	$195	$272	0.7×
Mental health services (assessment) HCPCS Code: `H0031`	—	$137	$140	1.0×
Family therapy session CPT Code: `90847`	—	$161	$173	0.9×
CT scan, head (with and without contrast) CPT Code: `70470`	—	$159	$258	0.6×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	—	$167	$303	0.6×
MRI, lower back (no contrast) CPT Code: `72148`	—	$176	$338	0.5×
MRI, knee or other leg joint CPT Code: `73721`	—	$186	$369	0.5×
Echocardiogram (heart ultrasound) CPT Code: `93306`	—	$172	$583	0.3×
Review of medical records for care CPT Code: `90889`	—	$127	$114	1.1×
Diagnostic mammogram (both breasts) CPT Code: `77066`	—	$140	$148	0.9×
Hepatitis B immune globulin HCPCS Code: `90371`	$2,202	$139	$151	0.9×
Psychotherapy session (60 minutes) CPT Code: `90837`	—	$161	$181	0.9×
Psychiatric evaluation (first visit) CPT Code: `90791`	—	$161	$185	0.9×
Mental health services (therapy) HCPCS Code: `H0032`	—	$94	$65	1.4×
Office visit, established patient (30-39 min) CPT Code: `99214`	$165	$119	$123	1.0×
Screening mammogram (both breasts) CPT Code: `77067`	—	$113	$123	0.9×
Office visit, established patient (20-29 min) CPT Code: `99213`	$111	$84	$87	1.0×
New patient office visit (30-44 min) CPT Code: `99203`	—	$104	$110	0.9×
Care planning with family CPT Code: `90887`	—	$96	$107	0.9×
Ultrasound, abdomen (complete) CPT Code: `76700`	$294	$104	$134	0.8×
Ultrasound, thyroid and neck CPT Code: `76536`	—	$98	$132	0.7×
CT scan, pelvis CPT Code: `72192`	—	$120	$163	0.7×
Ultrasound, pelvis CPT Code: `76856`	$316	$95	$130	0.7×
CT scan, chest (no contrast) CPT Code: `71250`	—	$120	$167	0.7×
CT scan, lower back (lumbar spine) CPT Code: `72131`	—	$117	$168	0.7×
CT scan, sinuses CPT Code: `70486`	—	$115	$166	0.7×
Psychotherapy session (45 minutes) CPT Code: `90834`	—	$115	$166	0.7×
CT scan, neck (cervical spine) CPT Code: `72125`	—	$117	$169	0.7×
CT scan, head (with contrast) CPT Code: `70460`	—	$137	$242	0.6×
CT scan, head (no contrast) CPT Code: `70450`	—	$106	$160	0.7×
Blood transfusion CPT Code: `36430`	$599	$83	$498	0.2×
Typhoid vaccine HCPCS Code: `90675`	$1,859	$320	$347	0.9×
Drug screening test HCPCS Code: `G0480`	—	$114	$116	1.0×
Pneumococcal vaccine HCPCS Code: `90732`	$636	$133	$140	0.9×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$138	$203	0.7×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	—	$80	$111	0.7×
Blood antibody screen CPT Code: `86850`	$127	$53	$46	1.2×
Speech therapy (language evaluation) CPT Code: `92507`	$70	$73	$86	0.8×
Ultrasound, abdomen (limited) CPT Code: `76705`	—	$78	$126	0.6×
Diagnostic procedure preparation HCPCS Code: `G0279`	—	$40	$35	1.1×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$155	$39	$39	1.0×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$230	$53	$56	0.9×
Pneumonia vaccine injection HCPCS Code: `G0009`	—	$46	$49	0.9×
Colorectal cancer screening HCPCS Code: `G0010`	—	$46	$49	0.9×
Behavioral health day program HCPCS Code: `H2012`	—	$62	$100	0.6×
Group therapy session CPT Code: `90853`	—	$53	$100	0.5×
X-ray, lower back CPT Code: `72110`	$273	$47	$112	0.4×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$84	$19	$14	1.4×
Blood test, clotting time (PTT) CPT Code: `85730`	$59	$8	$6	1.3×
Blood test, ferritin (iron stores) CPT Code: `82728`	$21	$18	$14	1.3×
Blood test, vitamin D CPT Code: `82306`	$63	$38	$31	1.2×
X-ray, neck (cervical spine) CPT Code: `72040`	—	$35	$93	0.4×
Blood test, lipase CPT Code: `83690`	$78	$9	$7	1.3×
Blood test, magnesium CPT Code: `83735`	$64	$9	$7	1.3×
Blood test, PSA (prostate screen) CPT Code: `84153`	$83	$24	$19	1.3×
Blood test, glucose (blood sugar) CPT Code: `82947`	$56	$5	$4	1.3×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$27	$5	$4	1.3×
Culture, bacterial CPT Code: `87070`	$40	$11	$9	1.2×
Blood test, vitamin B12 CPT Code: `82607`	$110	$19	$16	1.2×
X-ray, hip CPT Code: `73502`	$246	$42	$93	0.5×
Culture, blood CPT Code: `87040`	$63	$13	$11	1.2×
Blood test, thyroid (TSH) CPT Code: `84443`	$114	$21	$18	1.2×
Hepatitis C antibody test CPT Code: `86803`	$66	$17	$15	1.1×
Blood test, complete blood count (CBC) CPT Code: `85025`	$81	$9	$8	1.1×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$80	$20	$20	1.0×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	—	$26	$27	1.0×
Extended office visit (prolonged) HCPCS Code: `G2212`	—	$30	$33	0.9×
Hepatitis B vaccine HCPCS Code: `90744`	—	$32	$37	0.9×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$136	$38	$64	0.6×
X-ray, chest (two views) CPT Code: `71046`	$269	$30	$93	0.3×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$35	$4	$3	1.3×
Blood test, calcium CPT Code: `82310`	$47	$6	$5	1.2×
Blood test, creatinine (kidney) CPT Code: `82565`	$45	$6	$5	1.2×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$66	$12	$10	1.2×
Blood test, potassium CPT Code: `84132`	$35	$6	$5	1.2×
Blood test, sodium CPT Code: `84295`	$32	$6	$5	1.2×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$109	$13	$11	1.2×
Blood test, amylase CPT Code: `82150`	$94	$8	$7	1.1×
Blood test, basic metabolic panel CPT Code: `80048`	$98	$10	$9	1.1×
Blood test, liver function panel CPT Code: `80076`	$121	$10	$9	1.1×
X-ray, hand CPT Code: `73130`	—	$33	$93	0.4×
X-ray, ankle CPT Code: `73610`	$171	$32	$93	0.3×
X-ray, shoulder CPT Code: `73030`	$446	$31	$92	0.3×
X-ray, foot CPT Code: `73630`	$171	$31	$92	0.3×
Blood test, hemoglobin CPT Code: `85018`	$26	$3	$3	1.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$60	$5	$5	1.0×
Flu vaccine (high dose) HCPCS Code: `90656`	—	$23	$25	0.9×
Electrical stimulation therapy HCPCS Code: `G0283`	$80	$12	$14	0.9×
Speech therapy (group session) CPT Code: `92508`	$65	$23	$27	0.9×
Physical therapy (gait training) CPT Code: `97116`	$65	$28	$33	0.8×
Prosthetic fitting and training CPT Code: `97761`	$74	$38	$45	0.8×
Orthotic fitting and training CPT Code: `97760`	$66	$43	$51	0.8×
Physical therapy (functional capacity test) CPT Code: `97750`	$45	$32	$38	0.8×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$65	$33	$40	0.8×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$65	$31	$38	0.8×
Occupational therapy (self-care training) CPT Code: `97535`	$65	$31	$38	0.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$85	$28	$35	0.8×
Physical therapy (manual therapy) CPT Code: `97140`	$65	$26	$34	0.8×
Behavioral health living support HCPCS Code: `H2019`	—	$24	$34	0.7×
Flu vaccine injection HCPCS Code: `G0008`	$14	$14	$48	0.3×
X-ray, chest (single view) CPT Code: `71045`	$258	$23	$92	0.3×
Psychological testing evaluation CPT Code: `96136`	—	$30	$128	0.2×
Breathing treatment (nebulizer) CPT Code: `94640`	$136	$31	$201	0.2×
Psychological testing by technician CPT Code: `96138`	—	$40	$395	0.1×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$13	$25	0.5×
X-ray, pelvis CPT Code: `72170`	$191	$25	$110	0.2×

Showing top 25 high-impact procedures of 132 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 28.2%

Audit a Bill or Quote at Atrium Health Navicent Rehabilitation Hopsital (Zero PHI Required)

CMS CCN: 113029

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $36,014

1. Amount on Your Bill or Quote ($) Pre-filled with Atrium Health Navicent Rehabilitation Hopsital’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 501(r) AGB Cap: $24,366 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $24,366

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (28.2% of gross = $24,366).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Atrium Health Navicent Rehabilitation Hopsital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$55,659 Above Fair BaseRate

Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)

Your bill ($86,434) is $55,659 above the denoised Fair BaseRate ($30,775) and 3.7× the $23,504 Medicare rate.

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) 501(c)(3) Nonprofit Hospital

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

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (28.2% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

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

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

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

Higher-Quality, Above-Median Price Tier

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Atrium Health Navicent Rehabilitation Hopsital.

Price Index: 1.05× regional baseline

Quality: 54/100 CMS composite

Median Household Income$82,158U.S. Census ACS

Local Uninsured Share7.7%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 84/100 · Corroborated CMS CCN 113029

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 113029) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2025-11-19

Validated Rate Rows6,337 (CMS v3.0.0)

File Integrity DigestVerified · CCN 113029

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