How many shoppable procedure prices are published for Atrium Health Navicent the Medical Center?

Atrium Health Navicent the Medical Center in Macon, GA currently has 133 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Atrium Health Navicent the Medical Center's commercial prices compare to the fair BaseRate?

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

What is Atrium Health Navicent the Medical Center's CMS Care Compare overall star rating?

CMS Care Compare assigns Atrium Health Navicent the Medical Center an overall hospital quality rating of 2 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Government - Hospital District or Authority 636 Beds · rural Updated: 2025-11-19

Atrium Health Navicent the Medical Center

777 Hemlock Street, Macon, GA 31201 · 133 Priced Procedures · 59% Patient Recommendation

CMS Overall Rating 2 / 5 Stars

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.

85/100 · Verified

85/100Self-Pay Cash Beats Insurance 49% of the Time

File Completeness66

Price Logic96

Peer Alignment73

Clean Billing92

Real Cash Discount100

Regional Benchmark Tier

2-Star CMS clinical quality rating paired with 0.90× fair market pricing.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Atrium Health Navicent the Medical Center prices routine shoppable procedures near 0.8× Medicare (p50 0.85×) while skewing captive emergency, lab, and upper-quartile codes to 1.3× Medicare (p75 1.11×, +31% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#19 of 100 in GA · 18th State Percentile#620 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 49% of shoppable procedures (99/100 Cash Honesty)
2-Star CMS clinical rating with 59% patient recommendation (56/100 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)

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 (1.8×) & laboratory (3.0×) services average 1.63× higher multiples than routine shoppable care (0.8×)
Upper-quartile procedures (Q75 1.11×) jump +31% above the median procedure ratio (Q50 0.85×)
Consolidated metro market (HHI 5,733) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

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+31% Upper Tail

Q25 0.65× · Q50 0.85× · 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

0.5× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.8× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.8× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

3.0× MedicareFair

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

1.2× MedicareGood

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

49% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

2 CMS · 56/100Elevated

Procedure Prices at Atrium Health Navicent the Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 133 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`	—	$4,578	$13,413	0.3×
Total knee replacement CPT Code: `27447`	—	$4,538	$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`	—	$2,345	$2,680	0.9×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$2,201	$3,372	0.7×
Cataract surgery with lens implant CPT Code: `66984`	—	$2,151	$2,540	0.8×
Bunion correction surgery CPT Code: `28296`	—	$2,055	$3,446	0.6×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$1,480	$6,109	0.2×
Trauma team activation HCPCS Code: `G0390`	$6,451	$1,289	$1,453	0.9×
Inguinal hernia repair CPT Code: `49505`	$3,618	$1,160	$3,629	0.3×
Injection procedure for pain management HCPCS Code: `G0260`	—	$1,001	$855	1.2×
Breast lump removal CPT Code: `19120`	$5,135	$1,000	$3,875	0.3×
Colonoscopy with biopsy CPT Code: `45380`	—	$929	$1,256	0.7×
Upper endoscopy with biopsy CPT Code: `43239`	—	$669	$987	0.7×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$643	$981	0.7×
Sleep study (overnight, in lab) CPT Code: `95810`	$2,109	$560	$1,021	0.5×
MRI, brain (with and without contrast) CPT Code: `70553`	$3,019	$348	$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`	$3,464	$270	$448	0.6×
Neurobehavioral status check CPT Code: `96116`	—	$213	$231	0.9×
MRI, brain (no contrast) CPT Code: `70551`	$2,294	$224	$343	0.7×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$631	$194	$272	0.7×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,708	$159	$258	0.6×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$2,478	$167	$303	0.6×
MRI, lower back (no contrast) CPT Code: `72148`	$2,102	$176	$338	0.5×
MRI, knee or other leg joint CPT Code: `73721`	$1,791	$186	$369	0.5×
Mental health services (assessment) HCPCS Code: `H0031`	—	$137	$140	1.0×
Hepatitis B immune globulin HCPCS Code: `90371`	$2,202	$139	$151	0.9×
Family therapy session CPT Code: `90847`	$235	$157	$173	0.9×
Psychotherapy session (60 minutes) CPT Code: `90837`	$225	$157	$181	0.9×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,260	$172	$583	0.3×
Mental health services (therapy) HCPCS Code: `H0032`	—	$94	$65	1.4×
Office visit, established patient (30-39 min) CPT Code: `99214`	$201	$119	$123	1.0×
CT scan, chest (no contrast) CPT Code: `71250`	$1,460	$120	$167	0.7×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,495	$117	$168	0.7×
CT scan, sinuses CPT Code: `70486`	$1,318	$115	$166	0.7×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,582	$117	$169	0.7×
CT scan, head (with contrast) CPT Code: `70460`	$1,391	$137	$242	0.6×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$370	$140	$148	unverified
Office visit, established patient (20-29 min) CPT Code: `99213`	$144	$84	$87	1.0×
New patient office visit (30-44 min) CPT Code: `99203`	$147	$104	$110	0.9×
Care planning with family CPT Code: `90887`	—	$96	$107	0.9×
Ultrasound, abdomen (complete) CPT Code: `76700`	$469	$104	$134	0.8×
Ultrasound, thyroid and neck CPT Code: `76536`	$474	$98	$132	0.7×
CT scan, pelvis CPT Code: `72192`	$1,191	$120	$163	0.7×
Psychotherapy session (45 minutes) CPT Code: `90834`	$206	$121	$166	0.7×
Ultrasound, pelvis CPT Code: `76856`	$425	$95	$130	0.7×
CT scan, head (no contrast) CPT Code: `70450`	$1,342	$104	$160	0.7×
Psychological testing by technician CPT Code: `96138`	$106	$106	$395	0.3×
Screening mammogram (both breasts) CPT Code: `77067`	$344	$113	$123	unverified
Review of medical records for care CPT Code: `90889`	—	$127	$114	unverified
Blood transfusion CPT Code: `36430`	$585	$83	$498	0.2×
Typhoid vaccine HCPCS Code: `90675`	$1,779	$320	$347	0.9×
Drug screening test HCPCS Code: `G0480`	—	$114	$116	1.0×
Pneumococcal vaccine HCPCS Code: `90732`	$387	$133	$140	0.9×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$236	$145	$203	0.7×
Speech therapy (language evaluation) CPT Code: `92507`	$143	$73	$86	0.8×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$227	$84	$111	0.8×
Diagnostic procedure preparation HCPCS Code: `G0279`	—	$40	$35	1.1×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$136	$39	$39	1.0×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$228	$53	$56	0.9×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$92	$20	$20	1.0×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	—	$26	$27	1.0×
Flu vaccine injection HCPCS Code: `G0008`	$61	$45	$48	0.9×
Pneumonia vaccine injection HCPCS Code: `G0009`	$61	$45	$49	0.9×
Colorectal cancer screening HCPCS Code: `G0010`	$61	$45	$49	0.9×
Extended office visit (prolonged) HCPCS Code: `G2212`	—	$30	$33	0.9×
Physical therapy (gait training) CPT Code: `97116`	$71	$28	$33	0.8×
Prosthetic fitting and training CPT Code: `97761`	$72	$38	$45	0.8×
Orthotic fitting and training CPT Code: `97760`	$71	$43	$51	0.8×
Behavioral health day program HCPCS Code: `H2012`	—	$62	$100	0.6×
Ultrasound, abdomen (limited) CPT Code: `76705`	$396	$78	$126	0.6×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$131	$38	$64	0.6×
Group therapy session CPT Code: `90853`	$104	$53	$100	0.5×
Psychiatric evaluation (first visit) CPT Code: `90791`	$77	$77	$185	0.4×
X-ray, lower back CPT Code: `72110`	$284	$47	$112	0.4×
X-ray, neck (cervical spine) CPT Code: `72040`	$238	$35	$93	0.4×
Blood test, lipase CPT Code: `83690`	$80	$9	$7	1.3×
Blood test, glucose (blood sugar) CPT Code: `82947`	$55	$5	$4	1.3×
Blood test, ferritin (iron stores) CPT Code: `82728`	$112	$17	$14	1.2×
Blood test, vitamin D CPT Code: `82306`	$72	$37	$31	1.2×
Hepatitis B vaccine HCPCS Code: `90744`	$92	$32	$37	0.9×
X-ray, hip CPT Code: `73502`	$228	$42	$93	0.5×
Blood antibody screen CPT Code: `86850`	$130	$52	$46	unverified
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$29	$5	$4	1.3×
Culture, bacterial CPT Code: `87070`	$41	$11	$9	1.2×
Blood test, calcium CPT Code: `82310`	$53	$6	$5	1.2×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$71	$12	$10	1.2×
Blood test, potassium CPT Code: `84132`	$37	$6	$5	1.2×
Blood test, sodium CPT Code: `84295`	$34	$6	$5	1.2×
Blood test, vitamin B12 CPT Code: `82607`	$127	$19	$16	1.2×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$125	$13	$11	1.2×
Culture, blood CPT Code: `87040`	$72	$13	$11	1.2×
Blood test, clotting time (PTT) CPT Code: `85730`	$58	$7	$6	1.2×
Hepatitis C antibody test CPT Code: `86803`	$69	$17	$15	1.1×
Blood test, complete blood count (CBC) CPT Code: `85025`	$93	$9	$8	1.1×
Blood test, basic metabolic panel CPT Code: `80048`	$112	$10	$9	1.1×
Blood test, liver function panel CPT Code: `80076`	$139	$10	$9	1.1×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$60	$5	$5	1.0×
Flu vaccine (high dose) HCPCS Code: `90656`	$56	$23	$25	0.9×
Electrical stimulation therapy HCPCS Code: `G0283`	—	$12	$14	0.9×
Speech therapy (group session) CPT Code: `92508`	$63	$23	$27	0.9×
Physical therapy (functional capacity test) CPT Code: `97750`	$78	$32	$38	0.8×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$71	$33	$40	0.8×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$71	$31	$38	0.8×
Occupational therapy (self-care training) CPT Code: `97535`	$71	$31	$38	0.8×
X-ray, hand CPT Code: `73130`	$133	$33	$93	0.4×
X-ray, ankle CPT Code: `73610`	$133	$32	$93	0.3×
X-ray, shoulder CPT Code: `73030`	$233	$31	$92	0.3×
X-ray, foot CPT Code: `73630`	$138	$31	$92	0.3×
X-ray, chest (two views) CPT Code: `71046`	$301	$30	$93	0.3×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$37	$4	$3	1.3×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$71	$28	$35	0.8×
Physical therapy (manual therapy) CPT Code: `97140`	$112	$26	$34	0.8×
Behavioral health living support HCPCS Code: `H2019`	—	$24	$34	0.7×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$13	$25	0.5×
X-ray, chest (single view) CPT Code: `71045`	$245	$23	$92	0.3×
Psychological testing evaluation CPT Code: `96136`	$96	$30	$128	0.2×
X-ray, pelvis CPT Code: `72170`	$193	$25	$110	0.2×
Breathing treatment (nebulizer) CPT Code: `94640`	$131	$31	$201	0.2×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$88	$18	$14	unverified
Blood test, amylase CPT Code: `82150`	$96	$8	$7	unverified
Blood test, creatinine (kidney) CPT Code: `82565`	$48	$6	$5	unverified
Blood test, magnesium CPT Code: `83735`	$59	$8	$7	unverified
Blood test, PSA (prostate screen) CPT Code: `84153`	$73	$23	$19	unverified
Blood test, thyroid (TSH) CPT Code: `84443`	$118	$20	$18	unverified
Blood test, hemoglobin CPT Code: `85018`	$29	$3	$3	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	$2	$2	$86	unverified

Showing top 25 high-impact procedures of 133 total

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

Audit a Bill or Quote at Atrium Health Navicent the Medical Center (Zero PHI Required)

CMS CCN: 110107

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 the Medical Center’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 Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Atrium Health Navicent the Medical Center'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) For-Profit / Non-501(c)(3)

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

Public IRS & CMS ownership records classify Atrium Health Navicent the Medical Center 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 Overall2/5 Stars (2/5)

Safety Composite56/100

Would Recommend59%

Rated 9 or 10 (HCAHPS)59%

Median ER Wait184 min

Left ER Before Seen1%

30-Day Mortality vs U.S.worse

Unplanned Readmissionsame

Hip/Knee Complication Rate2.8%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionsame

C. diff Hospital-Onset Infectionbetter

Source: CMS Hospital Care Compare (1,342 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 Quality & Price Benchmark Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Atrium Health Navicent the Medical Center.

Price Index: 0.71× regional baseline

Quality: 34/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Alliant

-38.5%

Median Household Income$50,747U.S. Census ACS

Local Uninsured Share13.6%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 85/100 · Verified CMS CCN 110107

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 110107) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2025-11-19

Validated Rate Rows7,277 (CMS v3.0.0)

File Integrity DigestVerified · CCN 110107

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