How many shoppable procedure prices are published for Northeast Georgia Medical Center, Inc?

Northeast Georgia Medical Center, Inc in Gainesville, GA currently has 126 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Northeast Georgia Medical Center, Inc's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Northeast Georgia Medical Center, Inc's median negotiated commercial rate is 1.0× the regionally adjusted fair BaseRate benchmark.

What is Northeast Georgia Medical Center, Inc's CMS Care Compare overall star rating?

CMS Care Compare assigns Northeast Georgia Medical Center, Inc 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 Government - Local 657 Beds · urban Updated: 2026-01-01

Northeast Georgia Medical Center, Inc

743 Spring Street, Gainesville, GA 30501 · 126 Priced Procedures · 69% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

Near Fair BaseRate Benchmark

0.97×vs. Fair Market Price

Typical commercial prices here are 3% below the fair benchmark (0.97×) after accounting for local nurse/doctor wages and patient complexity.

79/100 · Corroborated

79/100Self-Pay Cash Beats Insurance 1% of the Time

File Completeness66

Price Logic96

Peer Alignment50

Clean Billing82

Real Cash Discount100

Regional Value Leader

3-Star CMS clinical quality rating paired with 0.97× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Northeast Georgia Medical Center, Inc prices shoppable and inpatient services (1.5× to 1.3× Medicare, divergence 0.87×) in alignment with regional hospital peers (0.97× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#30 of 100 in GA · 29th State Percentile#1,099 of 3,385 in U.S. · 32nd National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 3% below peer Fair BaseRate (0.97×)
Self-pay cash beats commercial insurance on 1% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (66/100 safety score) with 69% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (7.3% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.9× markup over Medicare rates
Commercial insurance median sits at 0.97× Fair BaseRate (1.5× Medicare), so insured patients should always compare the self-pay cash price before paying.
Even at low-cost facilities (0.97× 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 10,000) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.5× Medicare

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

Back-Door Captive & ER0.87× Divergence

1.3× Medicare

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

Quantile Tail Spread+7% Upper Tail

Q25 0.86× · Q50 0.97× · Q75 1.04×

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

1.5× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.9× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.9× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

0.5× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

4.1× MedicareElevated

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

0.7× MedicareGood

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

1% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 66/100Fair

Procedure Prices at Northeast Georgia Medical Center, Inc

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 126 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`	—	$68,134	$30,775	2.2×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$43,328	$19,087	2.3×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$41,632	$19,432	2.1×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$39,945	$17,936	2.2×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$19,238	$6,109	3.1×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$17,229	$8,223	2.1×
Cataract surgery with lens implant CPT Code: `66984`	—	$16,442	$2,540	unverified
Total hip replacement CPT Code: `27130`	—	$13,265	$13,413	1.0×
Total knee replacement CPT Code: `27447`	—	$13,265	$13,523	1.0×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$12,066	$3,372	3.6×
Inguinal hernia repair CPT Code: `49505`	—	$12,066	$3,629	3.3×
Bunion correction surgery CPT Code: `28296`	—	$9,843	$3,446	2.9×
Breast lump removal CPT Code: `19120`	—	$9,843	$3,875	2.5×
Colonoscopy with biopsy CPT Code: `45380`	—	$8,563	$1,256	6.8×
Upper endoscopy with biopsy CPT Code: `43239`	—	$8,563	$987	unverified
Colonoscopy (diagnostic) CPT Code: `45378`	—	$8,563	$981	unverified
Blood transfusion CPT Code: `36430`	$2,059	$2,059	$498	unverified
Trauma team activation HCPCS Code: `G0390`	$4,093	$1,344	$1,453	0.9×
Sleep study (overnight, in lab) CPT Code: `95810`	$3,673	$866	$1,021	0.8×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,226	$551	$583	0.9×
Behavioral health living support HCPCS Code: `H2019`	$385	$385	$34	11.3×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,186	$357	$448	0.8×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,859	$357	$511	0.7×
Residential substance abuse treatment HCPCS Code: `H2035`	$285	$285	$88	3.2×
Rabies immune globulin HCPCS Code: `90375`	$5,024	$288	$322	0.9×
Residential mental health treatment HCPCS Code: `H2036`	$285	$285	$406	0.7×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$422	$231	$148	1.6×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,356	$247	$272	0.9×
Breathing treatment (nebulizer) CPT Code: `94640`	$334	$221	$201	1.1×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,823	$244	$303	0.8×
MRI, lower back (no contrast) CPT Code: `72148`	$886	$244	$338	0.7×
MRI, brain (no contrast) CPT Code: `70551`	$1,150	$244	$343	0.7×
MRI, knee or other leg joint CPT Code: `73721`	$903	$244	$369	0.7×
Neurobehavioral status check CPT Code: `96116`	—	$218	$231	0.9×
Office visit, established patient (30-39 min) CPT Code: `99214`	$192	$192	$123	1.6×
New patient office visit (30-44 min) CPT Code: `99203`	$160	$160	$110	1.5×
Psychotherapy session (45 minutes) CPT Code: `90834`	$204	$178	$166	1.1×
Family therapy session CPT Code: `90847`	$480	$178	$173	1.0×
Psychotherapy session (60 minutes) CPT Code: `90837`	$480	$178	$181	1.0×
Psychiatric evaluation (first visit) CPT Code: `90791`	$480	$178	$185	1.0×
CT scan, head (with contrast) CPT Code: `70460`	$974	$180	$242	0.7×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,180	$180	$258	0.7×
Screening mammogram (both breasts) CPT Code: `77067`	$412	$191	$123	unverified
Office visit, established patient (20-29 min) CPT Code: `99213`	$114	$114	$87	1.3×
Psychological testing evaluation CPT Code: `96136`	—	$134	$128	1.0×
Hepatitis B immune globulin HCPCS Code: `90371`	$1,386	$138	$151	0.9×
Group therapy session CPT Code: `90853`	$198	$102	$100	1.0×
X-ray, hip CPT Code: `73502`	$245	$90	$93	1.0×
X-ray, pelvis CPT Code: `72170`	$314	$105	$110	1.0×
X-ray, shoulder CPT Code: `73030`	$385	$87	$92	0.9×
X-ray, foot CPT Code: `73630`	$245	$87	$92	0.9×
X-ray, lower back CPT Code: `72110`	$675	$105	$112	0.9×
X-ray, chest (two views) CPT Code: `71046`	$298	$87	$93	0.9×
X-ray, neck (cervical spine) CPT Code: `72040`	$245	$87	$93	0.9×
X-ray, hand CPT Code: `73130`	$330	$87	$93	0.9×
X-ray, ankle CPT Code: `73610`	$342	$87	$93	0.9×
Ultrasound, abdomen (limited) CPT Code: `76705`	$839	$108	$126	0.9×
Ultrasound, pelvis CPT Code: `76856`	$1,119	$108	$130	0.8×
Ultrasound, thyroid and neck CPT Code: `76536`	$667	$108	$132	0.8×
Ultrasound, abdomen (complete) CPT Code: `76700`	$1,157	$108	$134	0.8×
CT scan, head (no contrast) CPT Code: `70450`	$746	$107	$160	0.7×
CT scan, pelvis CPT Code: `72192`	$908	$107	$163	0.7×
CT scan, sinuses CPT Code: `70486`	$633	$107	$166	0.6×
CT scan, chest (no contrast) CPT Code: `71250`	$954	$107	$167	0.6×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$954	$107	$168	0.6×
CT scan, neck (cervical spine) CPT Code: `72125`	$878	$105	$169	0.6×
Hepatitis B vaccine HCPCS Code: `90744`	$325	$325	$37	8.8×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$312	$312	$39	8.0×
Typhoid vaccine HCPCS Code: `90675`	$1,332	$323	$347	0.9×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$215	$203	1.1×
Pneumococcal vaccine HCPCS Code: `90732`	—	$157	$140	1.1×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	—	$112	$111	1.0×
Drug screening test HCPCS Code: `G0480`	—	$117	$116	1.0×
Diagnostic procedure preparation HCPCS Code: `G0279`	—	$48	$35	1.4×
Blood test, vitamin D CPT Code: `82306`	$136	$32	$31	1.0×
Colorectal cancer screening HCPCS Code: `G0010`	—	$47	$49	1.0×
Orthotic fitting and training CPT Code: `97760`	$37	$48	$51	0.9×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$222	$60	$64	0.9×
Speech therapy (language evaluation) CPT Code: `92507`	$126	$79	$86	0.9×
Hospital observation (per hour) HCPCS Code: `G0378`	$54	$54	$86	0.6×
Review of medical records for care CPT Code: `90889`	—	$67	$114	0.6×
Flu vaccine (high dose) HCPCS Code: `90656`	$225	$26	$25	1.0×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	—	$28	$27	1.0×
Flu vaccine injection HCPCS Code: `G0008`	—	$47	$48	1.0×
Pneumonia vaccine injection HCPCS Code: `G0009`	—	$47	$49	1.0×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$34	$34	$38	0.9×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$531	$47	$56	0.8×
Care planning with family CPT Code: `90887`	—	$64	$107	0.6×
Blood test, sodium CPT Code: `84295`	$46	$5	$5	1.0×
Blood test, thyroid (TSH) CPT Code: `84443`	$115	$18	$18	1.0×
Physical therapy (functional capacity test) CPT Code: `97750`	$49	$35	$38	0.9×
Prosthetic fitting and training CPT Code: `97761`	$34	$39	$45	0.9×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$40	$4	$4	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$77	$8	$8	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$78	$6	$6	1.0×
Hepatitis C antibody test CPT Code: `86803`	$130	$15	$15	1.0×
Culture, bacterial CPT Code: `87070`	$151	$9	$9	1.0×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$191	$20	$20	1.0×
Electrical stimulation therapy HCPCS Code: `G0283`	$33	$13	$14	0.9×
Occupational therapy (self-care training) CPT Code: `97535`	$35	$34	$38	0.9×
X-ray, chest (single view) CPT Code: `71045`	$213	$57	$92	0.6×
Blood test, ferritin (iron stores) CPT Code: `82728`	$106	$15	$14	1.1×
Blood test, PSA (prostate screen) CPT Code: `84153`	$109	$20	$19	1.1×
Blood test, basic metabolic panel CPT Code: `80048`	$119	$9	$9	1.0×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$218	$11	$11	1.0×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$177	$14	$14	1.0×
Blood test, liver function panel CPT Code: `80076`	$171	$9	$9	1.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$75	$3	$3	1.0×
Blood test, amylase CPT Code: `82150`	$59	$7	$7	1.0×
Blood test, calcium CPT Code: `82310`	$54	$5	$5	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$43	$5	$5	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$44	$4	$4	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$85	$10	$10	1.0×
Blood test, lipase CPT Code: `83690`	$143	$7	$7	1.0×
Blood test, magnesium CPT Code: `83735`	$86	$7	$7	1.0×
Blood test, potassium CPT Code: `84132`	$46	$5	$5	1.0×
Physical therapy (manual therapy) CPT Code: `97140`	$31	$29	$34	0.9×
Speech therapy (group session) CPT Code: `92508`	$38	$23	$27	0.9×
Physical therapy (gait training) CPT Code: `97116`	$30	$28	$33	0.8×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$35	$36	$40	unverified
Blood test, clotting time (PT/INR) CPT Code: `85610`	$69	$4	$5	0.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$21	$28	$35	0.8×
Blood test, hemoglobin CPT Code: `85018`	$29	$2	$3	0.7×
Blood antibody screen CPT Code: `86850`	$179	$17	$46	0.4×
Blood test, vitamin B12 CPT Code: `82607`	$124	$16	$16	unverified
Culture, blood CPT Code: `87040`	$155	$11	$11	unverified

Showing top 25 high-impact procedures of 126 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 7.3%

Audit a Bill or Quote at Northeast Georgia Medical Center, Inc (Zero PHI Required)

CMS CCN: 110029

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $68,134

1. Amount on Your Bill or Quote ($) Pre-filled with Northeast Georgia Medical Center, Inc’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: $11,937 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $11,937

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (7.3% of gross = $11,937).

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

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Northeast Georgia Medical Center, Inc'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 +$132,747 Above Fair BaseRate

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

Your bill ($163,522) is $132,747 above the denoised Fair BaseRate ($30,775) and 7.0× 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: 581694098

Filing Period: 199104

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 (7.3% 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 Recommend69%

Rated 9 or 10 (HCAHPS)68%

Median ER Wait226 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate3.6%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionbetter

C. diff Hospital-Onset Infectionbetter

Source: CMS Hospital Care Compare (2,252 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 Northeast Georgia Medical Center, Inc.

Price Index: 1.00× regional baseline

Quality: 65/100 CMS composite

Median Household Income$77,430U.S. Census ACS

Local Uninsured Share16.7%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 79/100 · Corroborated CMS CCN 110029 EIN 581694098

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 110029) ↗ Verify IRS Form 990 (EIN 581694098) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-01-01

Validated Rate Rows1,028 (CMS v3.0.0)

File Integrity DigestVerified · CCN 110029

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