How many shoppable procedure prices are published for Piedmont Athens Regional Medical Center?

Piedmont Athens Regional Medical Center in Athens, GA currently has 103 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Piedmont Athens Regional Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Piedmont Athens Regional Medical Center's median negotiated commercial rate is 1.4× the regionally adjusted fair BaseRate benchmark.

What is Piedmont Athens Regional Medical Center's CMS Care Compare overall star rating?

CMS Care Compare assigns Piedmont Athens Regional Medical Center an overall hospital quality rating of 4 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Other 395 Beds · urban Updated: 2026-07-01

Piedmont Athens Regional Medical Center

1199 Prince Avenue, Athens, GA 30606 · 103 Priced Procedures · 78% Patient Recommendation

CMS Overall Rating 4 / 5 Stars

Above Fair Market · Negotiate

1.42×vs. Fair Market Price

Typical commercial prices here are +42% above the fair benchmark (1.42×) even after accounting for local nurse/doctor wages and patient complexity.

86/100 · Verified

86/100Self-Pay Cash Beats Insurance 71% of the Time

File Completeness85

Price Logic89

Peer Alignment76

Clean Billing79

Real Cash Discount100

High-Markup · Check Safety

3-Star CMS clinical quality rating paired with 1.42× fair market pricing.

Behavioral Pricing FingerprintHigh-HHI Market Leverage

Consolidated System Premium Pricer

Operating in a concentrated regional market (CBSA HHI 5,732), Piedmont Athens Regional Medical Center commands a 1.42× BaseRate commercial premium across insurers. Self-pay cash quotes, in-state peer hospitals, and freestanding outpatient facilities offer critical leverage against consolidated system pricing.

#74 of 100 in GA · 73rd State Percentile#2,501 of 3,385 in U.S. · 73rd National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.02× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 71% of shoppable procedures (99/100 Cash Honesty)
4-Star CMS clinical rating with 78% patient recommendation (70/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (21.9% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.5× markup over Medicare rates
Commercial insurance median sits at 1.39× Fair BaseRate (2.1× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 1.70×) jump +22% above the median procedure ratio (Q50 1.39×)
Consolidated metro market (HHI 5,732) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

2.1× Medicare

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

Back-Door Captive & ER0.62× Divergence

1.3× Medicare

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

Quantile Tail Spread+22% Upper Tail

Q25 1.02× · Q50 1.39× · Q75 1.70×

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

2.1× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.5× 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

0.7× MedicareGood

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

1.5× MedicareGood

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

71% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 70/100Fair

Procedure Prices at Piedmont Athens Regional Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 103 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`	$48,275	$48,924	$30,775	1.6×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$17,900	$29,419	$19,087	1.5×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$46,778	$29,213	$19,432	1.5×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	$38,926	$14,541	$17,936	0.8×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$9,350	$11,807	$8,223	1.4×
Colonoscopy with biopsy CPT Code: `45380`	$1,392	$4,258	$1,256	3.4×
Upper endoscopy with biopsy CPT Code: `43239`	$1,389	$3,993	$987	unverified
Trauma team activation HCPCS Code: `G0390`	$3,353	$3,353	$1,453	2.3×
Blood transfusion CPT Code: `36430`	$910	$2,193	$498	unverified
Sleep study (overnight, in lab) CPT Code: `95810`	$2,097	$1,732	$1,021	1.7×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,553	$1,553	$583	2.7×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,266	$916	$448	2.0×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,202	$916	$511	1.8×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$691	$574	$272	2.1×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,841	$584	$303	1.9×
MRI, lower back (no contrast) CPT Code: `72148`	$1,711	$584	$338	1.7×
MRI, brain (no contrast) CPT Code: `70551`	$1,343	$584	$343	1.7×
MRI, knee or other leg joint CPT Code: `73721`	$1,516	$584	$369	1.6×
CT scan, head (with contrast) CPT Code: `70460`	$1,125	$438	$242	1.8×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,271	$438	$258	1.7×
Hepatitis B immune globulin HCPCS Code: `90371`	$137	$320	$151	2.1×
Ultrasound, abdomen (complete) CPT Code: `76700`	$581	$242	$134	1.8×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$318	$266	$148	1.8×
CT scan, head (no contrast) CPT Code: `70450`	$1,083	$262	$160	1.6×
CT scan, pelvis CPT Code: `72192`	$1,060	$262	$163	1.6×
CT scan, sinuses CPT Code: `70486`	$863	$262	$166	1.6×
CT scan, chest (no contrast) CPT Code: `71250`	$1,005	$262	$167	1.6×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$912	$262	$168	1.6×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,189	$262	$169	1.6×
Ultrasound, thyroid and neck CPT Code: `76536`	$614	$260	$132	unverified
Speech therapy (group session) CPT Code: `92508`	$168	$168	$27	6.2×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$190	$190	$64	3.0×
Hospital observation (per hour) HCPCS Code: `G0378`	$64	$213	$86	2.5×
Ultrasound, pelvis CPT Code: `76856`	$482	$223	$130	1.7×
Screening mammogram (both breasts) CPT Code: `77067`	$281	$221	$123	unverified
Ultrasound, abdomen (limited) CPT Code: `76705`	$460	$183	$126	1.5×
Office visit, established patient (20-29 min) CPT Code: `99213`	$151	$151	$87	1.7×
Office visit, established patient (30-39 min) CPT Code: `99214`	$173	$173	$123	1.4×
Speech therapy (language evaluation) CPT Code: `92507`	$135	$135	$86	1.6×
New patient office visit (30-44 min) CPT Code: `99203`	$157	$157	$110	1.4×
Physical therapy (manual therapy) CPT Code: `97140`	$108	$108	$34	3.2×
X-ray, hip CPT Code: `73502`	$205	$118	$93	1.3×
X-ray, lower back CPT Code: `72110`	$445	$127	$112	1.1×
Physical therapy (functional capacity test) CPT Code: `97750`	$101	$101	$38	2.7×
Breathing treatment (nebulizer) CPT Code: `94640`	$116	$116	$201	0.6×
Occupational therapy (self-care training) CPT Code: `97535`	$83	$83	$38	2.2×
Orthotic fitting and training CPT Code: `97760`	$80	$80	$51	1.6×
X-ray, neck (cervical spine) CPT Code: `72040`	$286	$94	$93	1.0×
X-ray, hand CPT Code: `73130`	$200	$93	$93	1.0×
X-ray, ankle CPT Code: `73610`	$271	$93	$93	1.0×
X-ray, foot CPT Code: `73630`	$227	$86	$92	0.9×
X-ray, shoulder CPT Code: `73030`	$217	$83	$92	0.9×
Typhoid vaccine HCPCS Code: `90675`	$477	$559	$347	1.6×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$245	$224	$203	1.1×
Drug screening test HCPCS Code: `G0480`	$153	$180	$116	1.6×
Pneumococcal vaccine HCPCS Code: `90732`	$118	$156	$140	1.1×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$89	$89	$27	3.3×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$130	$111	$111	1.0×
Electrical stimulation therapy HCPCS Code: `G0283`	$62	$62	$14	4.4×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$76	$76	$35	2.2×
Physical therapy (gait training) CPT Code: `97116`	$71	$71	$33	2.2×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$72	$72	$40	1.8×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$65	$65	$38	1.7×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$95	$77	$56	1.4×
Prosthetic fitting and training CPT Code: `97761`	$61	$61	$45	1.4×
Colorectal cancer screening HCPCS Code: `G0010`	$62	$62	$49	1.3×
X-ray, chest (two views) CPT Code: `71046`	$155	$76	$93	0.8×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$80	$30	$20	1.5×
Blood test, ferritin (iron stores) CPT Code: `82728`	$67	$15	$14	1.1×
Blood test, vitamin D CPT Code: `82306`	$79	$32	$31	1.0×
Hepatitis B vaccine HCPCS Code: `90744`	$47	$37	$37	1.0×
Flu vaccine injection HCPCS Code: `G0008`	$42	$42	$48	0.9×
Pneumonia vaccine injection HCPCS Code: `G0009`	$42	$42	$49	0.9×
X-ray, chest (single view) CPT Code: `71045`	$124	$56	$92	0.6×
X-ray, pelvis CPT Code: `72170`	$207	$66	$110	0.6×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$63	$5	$3	1.7×
Blood test, glucose (blood sugar) CPT Code: `82947`	$38	$6	$4	1.5×
Blood test, clotting time (PTT) CPT Code: `85730`	$52	$9	$6	1.5×
Blood test, calcium CPT Code: `82310`	$30	$6	$5	1.2×
Blood test, creatinine (kidney) CPT Code: `82565`	$27	$6	$5	1.2×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$39	$6	$5	1.2×
Blood test, lipase CPT Code: `83690`	$77	$8	$7	1.1×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$54	$11	$10	1.1×
Hepatitis C antibody test CPT Code: `86803`	$121	$16	$15	1.1×
Blood test, PSA (prostate screen) CPT Code: `84153`	$101	$20	$19	1.1×
Blood test, basic metabolic panel CPT Code: `80048`	$131	$9	$9	1.0×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$147	$11	$11	1.0×
Blood test, liver function panel CPT Code: `80076`	$106	$9	$9	1.0×
Blood test, amylase CPT Code: `82150`	$77	$7	$7	1.0×
Blood test, vitamin B12 CPT Code: `82607`	$81	$16	$16	1.0×
Blood test, magnesium CPT Code: `83735`	$45	$7	$7	1.0×
Blood test, sodium CPT Code: `84295`	$31	$5	$5	1.0×
Blood test, thyroid (TSH) CPT Code: `84443`	$69	$18	$18	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$30	$4	$4	1.0×
Culture, blood CPT Code: `87040`	$151	$11	$11	1.0×
Flu vaccine (high dose) HCPCS Code: `90656`	$7	$24	$25	1.0×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$51	$34	$39	0.9×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$87	$12	$14	0.9×
Blood test, potassium CPT Code: `84132`	$33	$4	$5	0.8×
Blood antibody screen CPT Code: `86850`	$111	$11	$46	0.2×
Blood test, hemoglobin CPT Code: `85018`	$23	$4	$3	unverified
Blood test, complete blood count (CBC) CPT Code: `85025`	$62	$15	$8	unverified
Culture, bacterial CPT Code: `87070`	$109	$19	$9	unverified

Showing top 25 high-impact procedures of 103 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 21.9%

Audit a Bill or Quote at Piedmont Athens Regional Medical Center (Zero PHI Required)

CMS CCN: 110074

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash $48,275

Insurer Median $48,924

1. Amount on Your Bill or Quote ($) Pre-filled with Piedmont Athens Regional 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: $35,193 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $35,193

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (21.9% of gross = $35,193).

Step 2 · Cash vs. Insurance Arbitrage Save $112,642 Paying Cash

Self-Pay Cash Rate ($48,275) Beats Your Bill

Piedmont Athens Regional Medical Center's published 45 CFR § 180 self-pay cash rate is $48,275 (vs. $48,924 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$130,142 Above Fair BaseRate

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

Your bill ($160,917) is $130,142 above the denoised Fair BaseRate ($30,775) and 6.8× 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: 582179986

Filing Period: 199511

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 (21.9% 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 Composite70/100

Would Recommend78%

Rated 9 or 10 (HCAHPS)75%

Median ER Wait183 min

Left ER Before Seen2%

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 Infectionbetter

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 Piedmont Athens Regional Medical Center. Prior administrative notices do not necessarily reflect current compliance status.

2025-08-19·administrative_or_closure
Met Requirements
Recorded
2024-03-14·administrative_or_closure
Closure Notice
Recorded
2023-11-14·cap_corrective_action
CAP Request
Recorded
2023-08-08·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (1,444 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 Piedmont Athens Regional Medical Center.

Price Index: 1.00× regional baseline

Quality: 67/100 CMS composite

Median Household Income$52,267U.S. Census ACS

Local Uninsured Share11.1%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 86/100 · Verified CMS CCN 110074 EIN 582179986

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 110074) ↗ Verify IRS Form 990 (EIN 582179986) ↗ CMS HCRIS Cost Reports ↗

Published MRF File582179986_piedmont-athens-hospital_standardcharges.zip!582179986_piedmont-athens-hospital_standardcharges.csv

Publication / Vintage2026-07-01 · 75.48 MB

Validated Rate Rows2,085 (CMS v3.0.0)

File Integrity Digestcf289c95a0a1b3e34afe…

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