How many shoppable procedure prices are published for Hamilton Medical Center?

Hamilton Medical Center in Dalton, GA currently has 117 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Hamilton Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Hamilton Medical Center's median negotiated commercial rate is 1.3× the regionally adjusted fair BaseRate benchmark.

What is Hamilton Medical Center's CMS Care Compare overall star rating?

CMS Care Compare assigns Hamilton Medical Center an overall hospital quality rating of 3 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 239 Beds · urban Updated: 4/1/2026

Hamilton Medical Center

1200 Memorial Drive, Dalton, GA 30720 · 117 Priced Procedures · 66% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

Above Fair Market · Negotiate

1.26×vs. Fair Market Price

Typical commercial prices here are +26% above the fair benchmark (1.26×) even after accounting for local nurse/doctor wages and patient complexity.

75/100 · Corroborated

75/100Self-Pay Cash Beats Insurance 2% of the Time

File Completeness61

Price Logic88

Peer Alignment51

Clean Billing76

Real Cash Discount100

Regional Value Leader

3-Star CMS clinical quality rating paired with 1.26× fair market pricing.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Hamilton Medical Center prices routine shoppable procedures near 1.0× Medicare (p50 1.36×) while skewing captive emergency, lab, and upper-quartile codes to 1.8× Medicare (p75 1.48×, +9% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#54 of 100 in GA · 53rd State Percentile#2,156 of 3,385 in U.S. · 63rd National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.62× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 2% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (66/100 safety score) with 66% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (5.0% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.26× 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 (2.9×) services average 1.80× higher multiples than routine shoppable care (1.0×)
Specialty infusion drugs (J-codes) average 1.2× Medicare — verify per-unit billing on itemized statements
Consolidated metro market (HHI 8,391) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.0× Medicare

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

Back-Door Captive & ER1.80× Divergence

1.8× Medicare

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

Quantile Tail Spread+9% Upper Tail

Q25 0.62× · Q50 1.36× · Q75 1.48×

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

1.0× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.5× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.1× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.8× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

2.9× MedicareFair

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

1.2× MedicareGood

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

2% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 66/100Fair

Procedure Prices at Hamilton Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 117 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`	—	$80,231	$30,775	unverified
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$51,020	$19,087	unverified
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$49,023	$19,432	2.5×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$47,037	$17,936	2.6×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$20,288	$8,223	2.5×
Total hip replacement CPT Code: `27130`	—	$14,494	$13,413	1.1×
Total knee replacement CPT Code: `27447`	—	$14,494	$13,523	1.1×
Trauma team activation HCPCS Code: `G0390`	$8,116	$8,116	$1,453	5.6×
Cataract surgery with lens implant CPT Code: `66984`	—	$5,567	$2,540	unverified
Vaginal delivery (full package) CPT Code: `59400`	—	$5,302	$2,680	2.0×
C-section delivery (full package) CPT Code: `59510`	—	$5,302	$2,975	1.8×
Sleep study (overnight, in lab) CPT Code: `95810`	$4,761	$4,761	$1,021	4.7×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$3,547	$3,372	1.1×
Inguinal hernia repair CPT Code: `49505`	—	$3,547	$3,629	1.0×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$3,104	$3,104	$583	5.3×
Bunion correction surgery CPT Code: `28296`	—	$2,515	$3,446	0.7×
Breast lump removal CPT Code: `19120`	—	$2,515	$3,875	0.6×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$2,515	$6,109	0.4×
Upper endoscopy with biopsy CPT Code: `43239`	—	$2,219	$987	2.2×
Colonoscopy with biopsy CPT Code: `45380`	—	$2,219	$1,256	1.8×
Injection procedure for pain management HCPCS Code: `G0260`	—	$1,708	$855	2.0×
Blood transfusion CPT Code: `36430`	$1,325	$1,325	$498	unverified
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,100	$1,100	$272	4.0×
Family therapy session CPT Code: `90847`	$857	$857	$173	5.0×
Colonoscopy (diagnostic) CPT Code: `45378`	$850	$850	$981	0.9×
Psychiatric evaluation (first visit) CPT Code: `90791`	$617	$617	$185	3.3×
Psychotherapy session (45 minutes) CPT Code: `90834`	$583	$583	$166	3.5×
Rabies immune globulin HCPCS Code: `90375`	—	$463	$322	1.4×
Diagnostic procedure preparation HCPCS Code: `G0279`	$411	$411	$35	11.7×
Office visit, established patient (30-39 min) CPT Code: `99214`	$435	$435	$123	3.5×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$355	$355	$64	5.5×
Office visit, established patient (20-29 min) CPT Code: `99213`	$362	$362	$87	4.2×
Breathing treatment (nebulizer) CPT Code: `94640`	$375	$375	$201	1.9×
New patient office visit (30-44 min) CPT Code: `99203`	$328	$328	$110	3.0×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,820	$304	$448	0.7×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,703	$298	$511	0.6×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$251	$251	$35	7.2×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$248	$248	$40	6.2×
Psychotherapy session (60 minutes) CPT Code: `90837`	$270	$270	$181	1.5×
Hepatitis B immune globulin HCPCS Code: `90371`	—	$241	$151	1.6×
Occupational therapy (self-care training) CPT Code: `97535`	$179	$179	$38	4.7×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$172	$172	$38	4.5×
Physical therapy (functional capacity test) CPT Code: `97750`	$163	$163	$38	4.3×
Orthotic fitting and training CPT Code: `97760`	$187	$187	$51	3.7×
Group therapy session CPT Code: `90853`	$180	$180	$100	1.8×
MRI, knee or other leg joint CPT Code: `73721`	$2,557	$197	$369	0.5×
Physical therapy (gait training) CPT Code: `97116`	$137	$137	$33	4.2×
Physical therapy (manual therapy) CPT Code: `97140`	$136	$136	$34	4.0×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,439	$161	$258	0.6×
MRI, brain (no contrast) CPT Code: `70551`	$2,152	$180	$343	0.5×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$550	$154	$148	1.0×
MRI, lower back (no contrast) CPT Code: `72148`	$2,218	$172	$338	0.5×
Screening mammogram (both breasts) CPT Code: `77067`	$487	$128	$123	1.0×
Ultrasound, thyroid and neck CPT Code: `76536`	$574	$114	$132	0.9×
Ultrasound, pelvis CPT Code: `76856`	$1,174	$100	$130	0.8×
CT scan, sinuses CPT Code: `70486`	$1,333	$124	$166	0.7×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$7,040	$145	$303	0.5×
Ultrasound, abdomen (complete) CPT Code: `76700`	$1,178	$107	$134	0.8×
CT scan, pelvis CPT Code: `72192`	$1,099	$116	$163	0.7×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,365	$118	$169	0.7×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,562	$117	$168	0.7×
CT scan, chest (no contrast) CPT Code: `71250`	$3,518	$116	$167	0.7×
CT scan, head (with contrast) CPT Code: `70460`	$1,300	$135	$242	0.6×
Ultrasound, abdomen (limited) CPT Code: `76705`	$705	$82	$126	0.7×
CT scan, head (no contrast) CPT Code: `70450`	$3,518	$94	$160	0.6×
Typhoid vaccine HCPCS Code: `90675`	—	$541	$347	1.6×
Flu vaccine injection HCPCS Code: `G0008`	$199	$199	$48	4.1×
Pneumonia vaccine injection HCPCS Code: `G0009`	$199	$199	$49	4.1×
Colorectal cancer screening HCPCS Code: `G0010`	$199	$199	$49	4.1×
Pneumococcal vaccine HCPCS Code: `90732`	—	$220	$140	1.6×
Drug screening test HCPCS Code: `G0480`	$139	$172	$116	unverified
Electrical stimulation therapy HCPCS Code: `G0283`	$49	$49	$14	3.5×
Care planning with family CPT Code: `90887`	$66	$66	$107	0.6×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$59	$15	$10	1.5×
Flu vaccine (high dose) HCPCS Code: `90656`	—	$37	$25	1.5×
Hepatitis B vaccine HCPCS Code: `90744`	—	$51	$37	1.4×
Hospital observation (per hour) HCPCS Code: `G0378`	$70	$70	$86	0.8×
X-ray, hip CPT Code: `73502`	$468	$51	$93	0.5×
X-ray, lower back CPT Code: `72110`	$608	$54	$112	0.5×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$651	$16	$11	1.5×
Speech therapy (language evaluation) CPT Code: `92507`	$39	$39	$86	0.5×
X-ray, neck (cervical spine) CPT Code: `72040`	$677	$40	$93	0.4×
X-ray, hand CPT Code: `73130`	$488	$40	$93	0.4×
X-ray, ankle CPT Code: `73610`	$361	$39	$93	0.4×
Blood test, calcium CPT Code: `82310`	$128	$8	$5	1.6×
Blood test, creatinine (kidney) CPT Code: `82565`	$77	$8	$5	1.6×
Blood test, basic metabolic panel CPT Code: `80048`	$229	$13	$9	1.4×
Blood test, liver function panel CPT Code: `80076`	$208	$12	$9	1.3×
X-ray, shoulder CPT Code: `73030`	$422	$36	$92	0.4×
X-ray, foot CPT Code: `73630`	$487	$36	$92	0.4×
X-ray, chest (two views) CPT Code: `71046`	$188	$32	$93	0.3×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$121	$5	$3	1.7×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$74	$6	$4	1.5×
Blood test, clotting time (PTT) CPT Code: `85730`	$76	$9	$6	1.5×
Culture, bacterial CPT Code: `87070`	$240	$13	$9	1.4×
Blood test, amylase CPT Code: `82150`	$116	$10	$7	1.4×
Blood test, ferritin (iron stores) CPT Code: `82728`	$161	$20	$14	1.4×
Blood test, magnesium CPT Code: `83735`	$147	$10	$7	1.4×
Blood test, potassium CPT Code: `84132`	$95	$7	$5	1.4×
Blood test, sodium CPT Code: `84295`	$83	$7	$5	1.4×
Blood test, thyroid (TSH) CPT Code: `84443`	$228	$25	$18	1.4×
Blood test, hemoglobin CPT Code: `85018`	$43	$4	$3	1.3×
Blood test, lipase CPT Code: `83690`	$4	$4	$7	0.6×
Prosthetic fitting and training CPT Code: `97761`	$22	$22	$45	0.5×
Blood antibody screen CPT Code: `86850`	$121	$15	$46	0.3×
X-ray, chest (single view) CPT Code: `71045`	$275	$24	$92	0.3×
Blood test, vitamin D CPT Code: `82306`	$8	$8	$31	0.3×
X-ray, pelvis CPT Code: `72170`	$495	$27	$110	0.2×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$2	$2	$14	0.1×
Blood test, vitamin B12 CPT Code: `82607`	$119	$23	$16	unverified
Blood test, glucose (blood sugar) CPT Code: `82947`	$109	$6	$4	unverified
Blood test, PSA (prostate screen) CPT Code: `84153`	$221	$28	$19	unverified
Blood test, complete blood count (CBC) CPT Code: `85025`	$2	$2	$8	0.3×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$84	$7	$5	unverified
Hepatitis C antibody test CPT Code: `86803`	$47	$21	$15	unverified
Culture, blood CPT Code: `87040`	$325	$15	$11	unverified
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$9	$9	$20	unverified

Showing top 25 high-impact procedures of 117 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 5.0%

Audit a Bill or Quote at Hamilton Medical Center (Zero PHI Required)

CMS CCN: 110001

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $80,231

1. Amount on Your Bill or Quote ($) Pre-filled with Hamilton 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 501(r) AGB Cap: $9,647 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $9,647

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (5.0% of gross = $9,647).

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

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Hamilton 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 +$161,779 Above Fair BaseRate

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

Your bill ($192,554) is $161,779 above the denoised Fair BaseRate ($30,775) and 8.2× 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)

EIN: 581519911

Filing Period: 198308

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 (5.0% 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 ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall3/5 Stars (3/5)

Safety Composite66/100

Would Recommend66%

Rated 9 or 10 (HCAHPS)68%

Median ER Wait187 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

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

CMS Price Transparency Administrative Enforcement Log

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

2023-07-12·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare (634 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 Hamilton Medical Center.

Price Index: 1.00× regional baseline

Quality: 60/100 CMS composite

Median Household Income$64,262U.S. Census ACS

Local Uninsured Share17.5%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 75/100 · Corroborated CMS CCN 110001 EIN 581519911

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 110001) ↗ Verify IRS Form 990 (EIN 581519911) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage4/1/2026

Validated Rate Rows175 (CMS v3.0.0)

File Integrity DigestVerified · CCN 110001

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