How many shoppable procedure prices are published for Piedmont Newton Hospital?

Piedmont Newton Hospital in Covington, GA currently has 99 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Piedmont Newton Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Piedmont Newton Hospital's median negotiated commercial rate is 1.8× the regionally adjusted fair BaseRate benchmark.

What is Piedmont Newton Hospital's CMS Care Compare overall star rating?

CMS Care Compare assigns Piedmont Newton Hospital 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 94 Beds · urban Updated: 2026-07-01

Piedmont Newton Hospital

5126 Hospital Drive Ne, Covington, GA 30014 · 99 Priced Procedures · 61% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

High Markup · Shop Alternatives

1.83×vs. Fair Market Price

Typical commercial prices here are +83% above the fair benchmark (1.83×) even after accounting for local nurse/doctor wages and patient complexity.

88/100 · Verified

88/100Self-Pay Cash Beats Insurance 72% of the Time

File Completeness95

Price Logic92

Peer Alignment78

Clean Billing73

Real Cash Discount100

High Price · Lower Safety

2-Star CMS clinical quality rating paired with 1.83× fair market pricing.

Behavioral Pricing FingerprintUpper-Quartile Spread · +39% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Piedmont Newton Hospital prices routine shoppable procedures at 4.8× Medicare (median 1.86× Fair BaseRate) while upper-quartile commercial rates jump +39% to 2.59× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#92 of 100 in GA · 91st State Percentile#2,972 of 3,385 in U.S. · 87th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.24× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 72% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (56/100 safety score) with 61% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (23.6% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 3.5× markup over Medicare rates
Commercial insurance median sits at 1.86× Fair BaseRate (4.8× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 2.59×) jump +39% above the median procedure ratio (Q50 1.86×)
Unnegotiated chargemaster list prices average 16.1× Medicare (14¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

4.8× Medicare

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

Back-Door Captive & ER0.33× Divergence

1.6× Medicare

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

Quantile Tail Spread+39% Upper Tail

Q25 1.24× · Q50 1.86× · Q75 2.59×

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

4.8× MedicareWatchout

Outpatient Surgery & ORBack-Door Captive

3.5× MedicareElevated

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

4.0× MedicareElevated

Back-Door Captive ER VisitsBack-Door Captive

3.5× MedicareElevated

Inpatient Lab & PathologyBack-Door Captive

1.4× MedicareGood

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

3.0× MedicareFair

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

72% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 56/100Elevated

Procedure Prices at Piedmont Newton Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 99 published procedures.

Sort:

Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Heart stent placement (inpatient stay) MS-DRG Code: `322`	$38,557	$38,557	$17,936	2.1×
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	$55,549	$27,544	$30,775	0.9×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$20,742	$20,742	$19,087	1.1×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$45,568	$17,376	$19,432	0.9×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$11,214	$8,396	$8,223	1.0×
Trauma team activation HCPCS Code: `G0390`	$3,353	$8,384	$1,453	unverified
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,553	$3,551	$583	unverified
Colonoscopy with biopsy CPT Code: `45380`	$1,392	$3,247	$1,256	2.6×
Upper endoscopy with biopsy CPT Code: `43239`	$1,389	$3,230	$987	unverified
Sleep study (overnight, in lab) CPT Code: `95810`	$2,097	$2,654	$1,021	unverified
MRI, knee or other leg joint CPT Code: `73721`	$1,516	$2,254	$369	unverified
Blood transfusion CPT Code: `36430`	$910	$2,214	$498	4.4×
CT scan, head (with contrast) CPT Code: `70460`	$1,125	$1,933	$242	unverified
CT scan, neck (cervical spine) CPT Code: `72125`	$1,189	$1,933	$169	unverified
MRI, brain (no contrast) CPT Code: `70551`	$1,343	$1,605	$343	unverified
Ultrasound, leg veins (duplex) CPT Code: `93970`	$691	$1,566	$272	unverified
CT scan, head (with and without contrast) CPT Code: `70470`	$1,271	$1,250	$258	unverified
CT scan, lower back (lumbar spine) CPT Code: `72131`	$912	$1,250	$168	unverified
CT scan, pelvis CPT Code: `72192`	$1,060	$1,250	$163	unverified
MRI, brain (with and without contrast) CPT Code: `70553`	$2,202	$955	$511	1.9×
MRI, lower back (no contrast) CPT Code: `72148`	$1,711	$955	$338	unverified
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,266	$916	$448	2.0×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,841	$630	$303	unverified
CT scan, head (no contrast) CPT Code: `70450`	$1,083	$567	$160	unverified
CT scan, sinuses CPT Code: `70486`	$863	$567	$166	unverified
CT scan, chest (no contrast) CPT Code: `71250`	$1,005	$567	$167	unverified
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$190	$439	$64	unverified
Office visit, established patient (30-39 min) CPT Code: `99214`	$173	$420	$123	unverified
Ultrasound, thyroid and neck CPT Code: `76536`	$614	$389	$132	unverified
Ultrasound, abdomen (complete) CPT Code: `76700`	$581	$364	$134	unverified
Speech therapy (group session) CPT Code: `92508`	$168	$371	$27	unverified
New patient office visit (30-44 min) CPT Code: `99203`	$157	$382	$110	unverified
Office visit, established patient (20-29 min) CPT Code: `99213`	$151	$367	$87	unverified
Ultrasound, pelvis CPT Code: `76856`	$482	$334	$130	unverified
Speech therapy (language evaluation) CPT Code: `92507`	$135	$338	$86	unverified
Diagnostic mammogram (both breasts) CPT Code: `77066`	$318	$275	$148	1.9×
Hepatitis B immune globulin HCPCS Code: `90371`	$115	$269	$151	1.8×
Breathing treatment (nebulizer) CPT Code: `94640`	$116	$282	$201	1.4×
Ultrasound, abdomen (limited) CPT Code: `76705`	$460	$274	$126	unverified
Screening mammogram (both breasts) CPT Code: `77067`	$281	$275	$123	unverified
Physical therapy (manual therapy) CPT Code: `97140`	$108	$294	$34	unverified
Physical therapy (functional capacity test) CPT Code: `97750`	$101	$276	$38	unverified
Physical therapy (therapeutic exercise) CPT Code: `97110`	$76	$215	$35	unverified
Occupational therapy (self-care training) CPT Code: `97535`	$83	$229	$38	unverified
Orthotic fitting and training CPT Code: `97760`	$80	$227	$51	unverified
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$65	$185	$38	unverified
Physical therapy (gait training) CPT Code: `97116`	$71	$201	$33	unverified
Occupational therapy (therapeutic activities) CPT Code: `97530`	$72	$203	$40	unverified
X-ray, hip CPT Code: `73502`	$205	$150	$93	1.6×
X-ray, lower back CPT Code: `72110`	$445	$156	$112	1.4×
Prosthetic fitting and training CPT Code: `97761`	$61	$177	$45	unverified
Electrical stimulation therapy HCPCS Code: `G0283`	$62	$176	$14	unverified
X-ray, neck (cervical spine) CPT Code: `72040`	$286	$118	$93	1.3×
X-ray, hand CPT Code: `73130`	$200	$115	$93	1.2×
X-ray, ankle CPT Code: `73610`	$271	$115	$93	1.2×
X-ray, foot CPT Code: `73630`	$227	$107	$92	1.2×
X-ray, shoulder CPT Code: `73030`	$217	$104	$92	1.1×
X-ray, chest (two views) CPT Code: `71046`	$155	$96	$93	1.0×
Hospital observation (per hour) HCPCS Code: `G0378`	$102	$85	$86	1.0×
X-ray, pelvis CPT Code: `72170`	$207	$87	$110	0.8×
Typhoid vaccine HCPCS Code: `90675`	$787	$860	$347	unverified
Drug screening test HCPCS Code: `G0480`	$153	$252	$116	unverified
Colorectal cancer screening HCPCS Code: `G0010`	$62	$151	$49	unverified
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$177	$112	$111	1.0×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$142	$92	$56	unverified
Flu vaccine injection HCPCS Code: `G0008`	$42	$103	$48	unverified
Pneumonia vaccine injection HCPCS Code: `G0009`	$42	$103	$49	unverified
Hepatitis B vaccine HCPCS Code: `90744`	$68	$51	$37	1.4×
X-ray, chest (single view) CPT Code: `71045`	$124	$72	$92	0.8×
Blood test, vitamin D CPT Code: `82306`	$79	$38	$31	unverified
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$80	$42	$20	unverified
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$89	$58	$27	unverified
Urinalysis (automated, with microscopy) CPT Code: `81001`	$63	$7	$3	2.3×
Blood test, clotting time (PTT) CPT Code: `85730`	$55	$13	$6	2.2×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$39	$9	$5	1.8×
Blood test, hemoglobin CPT Code: `85018`	$23	$5	$3	1.7×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$30	$5	$4	1.3×
Blood test, basic metabolic panel CPT Code: `80048`	$131	$11	$9	1.2×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$147	$13	$11	1.2×
Blood test, amylase CPT Code: `82150`	$77	$8	$7	1.1×
Blood test, liver function panel CPT Code: `80076`	$106	$10	$9	1.1×
Blood antibody screen CPT Code: `86850`	$111	$13	$46	0.3×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$98	$17	$14	unverified
Blood test, calcium CPT Code: `82310`	$30	$7	$5	unverified
Blood test, creatinine (kidney) CPT Code: `82565`	$33	$7	$5	unverified
Blood test, vitamin B12 CPT Code: `82607`	$81	$19	$16	unverified
Blood test, ferritin (iron stores) CPT Code: `82728`	$67	$17	$14	unverified
Blood test, glucose (blood sugar) CPT Code: `82947`	$38	$9	$4	unverified
Blood test, average blood sugar (A1c) CPT Code: `83036`	$54	$12	$10	unverified
Blood test, lipase CPT Code: `83690`	$77	$9	$7	unverified
Blood test, magnesium CPT Code: `83735`	$45	$9	$7	unverified
Blood test, potassium CPT Code: `84132`	$33	$6	$5	unverified
Blood test, PSA (prostate screen) CPT Code: `84153`	$101	$24	$19	unverified
Blood test, sodium CPT Code: `84295`	$31	$6	$5	unverified
Blood test, thyroid (TSH) CPT Code: `84443`	$73	$21	$18	unverified
Blood test, complete blood count (CBC) CPT Code: `85025`	$62	$17	$8	unverified
Hepatitis C antibody test CPT Code: `86803`	$121	$18	$15	unverified
Culture, blood CPT Code: `87040`	—	—	$11	—
Culture, bacterial CPT Code: `87070`	$116	$19	$9	unverified

Showing top 25 high-impact procedures of 99 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 23.6%

Audit a Bill or Quote at Piedmont Newton Hospital (Zero PHI Required)

CMS CCN: 110018

CPT 322

Select Procedure to Audit:

Fair BaseRate™ $17,936

Medicare Rate $12,807

Self-Pay Cash $38,557

Insurer Median $38,557

1. Amount on Your Bill or Quote ($) Pre-filled with Piedmont Newton Hospital’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: $398 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $398

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (23.6% of gross = $398).

Step 2 · Cash vs. Insurance Arbitrage Published Cash: $38,557

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Piedmont Newton Hospital's published 45 CFR § 180 self-pay cash rate is $38,557 (vs. $38,557 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target Target: $17,936 Fair BaseRate

Negotiate Toward $17,936 Fair BaseRate ($12,807 Medicare)

Your entered amount is at or below the modeled Fair BaseRate benchmark ($17,936).

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: 582155150

Filing Period: 199504

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 (23.6% 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 Overall2/5 Stars (2/5)

Safety Composite56/100

Would Recommend61%

Rated 9 or 10 (HCAHPS)60%

Median ER Wait214 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate4%

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 Piedmont Newton Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2025-08-19·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare (379 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

Above-Benchmark Price Tier

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Piedmont Newton Hospital.

Price Index: 1.35× regional baseline

Quality: 47/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Kaiser Permanente

+89.1%

Median Household Income$73,732U.S. Census ACS

Local Uninsured Share12.2%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 88/100 · Verified CMS CCN 110018 EIN 582155150

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 110018) ↗ Verify IRS Form 990 (EIN 582155150) ↗ CMS HCRIS Cost Reports ↗

Published MRF File582155150_piedmont-newton-hospital_standardcharges.zip!582155150_piedmont-newton-hospital_standardcharges.csv

Publication / Vintage2026-07-01 · 65.60 MB

Validated Rate Rows1,773 (CMS v3.0.0)

File Integrity Digest175ee591070c6895ff1a…

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