Phoebe Worth Medical Center
807 South Isabella Street, Sylvester, GA 31791 · 79 Priced Procedures
Typical commercial prices here are +35% above the fair benchmark (1.35×) even after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Consolidated System Premium Pricer
Operating in a concentrated regional market (CBSA HHI 9,780), Phoebe Worth Medical Center commands a 1.35× BaseRate commercial premium across insurers. Self-pay cash quotes, in-state peer hospitals, and freestanding outpatient facilities offer critical leverage against consolidated system pricing.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 1.14× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 0% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (69/100 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 (60.0% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (1.35× 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.
- Commercial insurance median sits at 1.34× Fair BaseRate (1.7× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Specialty infusion drugs (J-codes) average 1.3× Medicare — verify per-unit billing on itemized statements
- Consolidated metro market (HHI 9,780) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Phoebe Worth Medical Center
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 79 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Total knee replacement CPT Code: 27447 | $3,443 | 0.3× |
| Total hip replacement CPT Code: 27130 | $3,407 | 0.3× |
| C-section delivery (full package) CPT Code: 59510 | $2,074 | 0.7× |
| Vaginal delivery (full package) CPT Code: 59400 | $1,880 | 0.7× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $1,683 | 0.5× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $1,561 | 0.3× |
| Bunion correction surgery CPT Code: 28296 | $1,310 | 0.4× |
| Inguinal hernia repair CPT Code: 49505 | $1,043 | 0.3× |
| Breast lump removal CPT Code: 19120 | $788 | 0.2× |
| Colonoscopy with biopsy CPT Code: 45380 | $703 | 0.6× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $660 | 1.3× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $634 | 0.6× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $575 | 1.3× |
| Upper endoscopy with biopsy CPT Code: 43239 | $538 | 0.5× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $450 | 1.5× |
| MRI, lower back (no contrast) CPT Code: 72148 | $450 | 1.3× |
| MRI, brain (no contrast) CPT Code: 70551 | $450 | 1.3× |
| MRI, knee or other leg joint CPT Code: 73721 | $450 | 1.2× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $400 | 1.6× |
| CT scan, head (with contrast) CPT Code: 70460 | $350 | 1.4× |
| CT scan, head (no contrast) CPT Code: 70450 | $250 | 1.6× |
| CT scan, pelvis CPT Code: 72192 | $250 | 1.5× |
| CT scan, sinuses CPT Code: 70486 | $250 | 1.5× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $250 | 1.5× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $250 | 1.5× |
Audit a Bill or Quote at Phoebe Worth Medical Center (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $3,443
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (60.0% of gross = $3,443).
Self-Pay Cash Rate ($3,443) Beats Your Bill
Phoebe Worth Medical Center's published 45 CFR § 180 self-pay cash rate is $3,443 (vs. $3,443 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $13,523 Fair BaseRate ($13,117 Medicare)
Your entered amount is at or below the modeled Fair BaseRate benchmark ($13,523).
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (60.0% 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.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Phoebe Worth Medical Center.
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
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.