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

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

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

Across scored shoppable procedures, Piedmont Walton Hospital's median negotiated commercial rate is 1.6× the regionally adjusted fair BaseRate benchmark.

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

CMS Care Compare assigns Piedmont Walton Hospital 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 Proprietary 76 Beds · urban Updated: 2026-07-01

Piedmont Walton Hospital

2151 W Spring Street, Monroe, GA 30655 · 99 Priced Procedures · 66% Patient Recommendation

CMS Overall Rating 4 / 5 Stars

High Markup · Shop Alternatives

1.59×vs. Fair Market Price

Typical commercial prices here are +59% above the fair benchmark (1.59×) even after accounting for local nurse/doctor wages and patient complexity.

89/100 · Verified

89/100Self-Pay Cash Beats Insurance 82% of the Time

File Completeness95

Price Logic94

Peer Alignment80

Clean Billing73

Real Cash Discount100

High-Markup · Check Safety

3-Star CMS clinical quality rating paired with 1.59× fair market pricing.

Behavioral Pricing FingerprintHigh Insurer Rate · Deep Cash Discount

Cash-Arbitrage Bifurcated Pricer

Piedmont Walton Hospital maintains elevated commercial insurance contracts (1.59× Fair BaseRate) while offering direct self-pay cash discounts that beat commercial negotiated medians on 82% of procedures. High-deductible and uninsured patients should always request the self-pay cash rate prior to billing.

#85 of 100 in GA · 84th State Percentile#2,756 of 3,385 in U.S. · 81st National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.87× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 82% of shoppable procedures (99/100 Cash Honesty)
4-Star CMS clinical rating with 66% patient recommendation (67/100 safety score)
Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.7× markup over Medicare rates
Commercial insurance median sits at 1.56× Fair BaseRate (2.4× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 1.93×) jump +24% above the median procedure ratio (Q50 1.56×)
Unnegotiated chargemaster list prices average 16.2× Medicare (17¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

2.4× Medicare

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

Back-Door Captive & ER0.42× Divergence

1.0× Medicare

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

Quantile Tail Spread+24% Upper Tail

Q25 0.87× · Q50 1.56× · Q75 1.93×

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

2.4× MedicareFair

Outpatient Surgery & ORBack-Door Captive

1.7× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.0× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.7× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

0.8× MedicareGood

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

1.5× MedicareGood

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

82% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 67/100Fair

Procedure Prices at Piedmont Walton 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.

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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`	$55,549	$48,046	$30,775	1.6×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$19,059	$28,891	$19,087	1.5×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$36,628	$28,689	$19,432	1.5×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	$38,557	$26,221	$17,936	1.5×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$9,555	$7,699	$8,223	0.9×
Upper endoscopy with biopsy CPT Code: `43239`	$1,389	$3,792	$987	3.8×
Colonoscopy with biopsy CPT Code: `45380`	$1,392	$3,792	$1,256	3.0×
Trauma team activation HCPCS Code: `G0390`	$3,353	$3,353	$1,453	2.3×
Sleep study (overnight, in lab) CPT Code: `95810`	$2,097	$1,732	$1,021	1.7×
Blood transfusion CPT Code: `36430`	$910	$1,569	$498	3.2×
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	$691	$272	2.5×
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×
Office visit, established patient (30-39 min) CPT Code: `99214`	$173	$296	$123	2.4×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$318	$318	$148	2.1×
Screening mammogram (both breasts) CPT Code: `77067`	$281	$281	$123	2.3×
Ultrasound, thyroid and neck CPT Code: `76536`	$614	$260	$132	2.0×
Ultrasound, abdomen (complete) CPT Code: `76700`	$581	$242	$134	1.8×
Hepatitis B immune globulin HCPCS Code: `90371`	$109	$262	$151	1.7×
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×
X-ray, lower back CPT Code: `72110`	$445	$262	$112	unverified
X-ray, pelvis CPT Code: `72170`	$207	$262	$110	unverified
New patient office visit (30-44 min) CPT Code: `99203`	$157	$269	$110	unverified
Office visit, established patient (20-29 min) CPT Code: `99213`	$151	$259	$87	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	$64	$213	$86	2.5×
Ultrasound, pelvis CPT Code: `76856`	$482	$223	$130	1.7×
X-ray, chest (single view) CPT Code: `71045`	$124	$216	$92	unverified
X-ray, chest (two views) CPT Code: `71046`	$155	$216	$93	unverified
X-ray, neck (cervical spine) CPT Code: `72040`	$286	$216	$93	unverified
X-ray, shoulder CPT Code: `73030`	$217	$216	$92	unverified
X-ray, hand CPT Code: `73130`	$200	$216	$93	unverified
X-ray, hip CPT Code: `73502`	$205	$216	$93	unverified
X-ray, ankle CPT Code: `73610`	$271	$216	$93	unverified
X-ray, foot CPT Code: `73630`	$227	$216	$92	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×
Ultrasound, abdomen (limited) CPT Code: `76705`	$460	$183	$126	1.5×
Speech therapy (language evaluation) CPT Code: `92507`	$135	$135	$86	1.6×
Physical therapy (manual therapy) CPT Code: `97140`	$108	$108	$34	3.2×
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×
Typhoid vaccine HCPCS Code: `90675`	$787	$787	$347	2.3×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$106	$173	$111	1.6×
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×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$95	$92	$56	1.6×
Drug screening test HCPCS Code: `G0480`	$153	$103	$116	0.9×
Hepatitis B vaccine HCPCS Code: `90744`	$68	$65	$37	1.8×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$65	$65	$38	1.7×
Prosthetic fitting and training CPT Code: `97761`	$61	$61	$45	1.4×
Colorectal cancer screening HCPCS Code: `G0010`	$62	$62	$49	1.3×
Flu vaccine injection HCPCS Code: `G0008`	$42	$42	$48	0.9×
Pneumonia vaccine injection HCPCS Code: `G0009`	$42	$42	$49	0.9×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$63	$3	$3	1.0×
Blood test, calcium CPT Code: `82310`	$30	$5	$5	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$27	$5	$5	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$38	$4	$4	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$30	$4	$4	1.0×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$147	$10	$11	0.9×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$54	$9	$10	0.9×
Blood test, PSA (prostate screen) CPT Code: `84153`	$101	$17	$19	0.9×
Blood test, basic metabolic panel CPT Code: `80048`	$131	$8	$9	0.9×
Culture, bacterial CPT Code: `87070`	$119	$8	$9	0.9×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$89	$24	$27	0.9×
Blood test, vitamin B12 CPT Code: `82607`	$81	$14	$16	0.9×
Blood test, complete blood count (CBC) CPT Code: `85025`	$62	$7	$8	0.9×
Blood test, vitamin D CPT Code: `82306`	$79	$27	$31	0.9×
Hepatitis C antibody test CPT Code: `86803`	$121	$13	$15	0.9×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$87	$12	$14	0.9×
Blood test, amylase CPT Code: `82150`	$77	$6	$7	0.9×
Blood test, ferritin (iron stores) CPT Code: `82728`	$67	$12	$14	0.9×
Blood test, lipase CPT Code: `83690`	$77	$6	$7	0.9×
Blood test, magnesium CPT Code: `83735`	$45	$6	$7	0.9×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$80	$17	$20	0.8×
Blood test, thyroid (TSH) CPT Code: `84443`	$69	$15	$18	0.8×
Blood test, clotting time (PTT) CPT Code: `85730`	$52	$5	$6	0.8×
Culture, blood CPT Code: `87040`	$151	$9	$11	0.8×
Blood test, potassium CPT Code: `84132`	$33	$4	$5	0.8×
Blood test, sodium CPT Code: `84295`	$31	$4	$5	0.8×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$39	$4	$5	0.8×
Blood test, liver function panel CPT Code: `80076`	$106	$7	$9	0.8×
Blood test, hemoglobin CPT Code: `85018`	$23	$2	$3	0.7×
Blood antibody screen CPT Code: `86850`	$111	$9	$46	0.2×

Showing top 25 high-impact procedures of 99 total

Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

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

CMS CCN: 110046

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash $55,549

Insurer Median $48,046

1. Amount on Your Bill or Quote ($) Pre-filled with Piedmont Walton 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 274% of 2026 FPL

Above Standard 400% FPL Financial-Assistance Ceiling

At 274% FPL, you exceed the standard 400% FPL tier, though medical-hardship caps (when bills exceed 10% of annual income) may still apply.

Step 2 · Cash vs. Insurance Arbitrage Save $129,613 Paying Cash

Self-Pay Cash Rate ($55,549) Beats Your Bill

Piedmont Walton Hospital's published 45 CFR § 180 self-pay cash rate is $55,549 (vs. $48,046 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$154,387 Above Fair BaseRate

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

Your bill ($185,162) is $154,387 above the denoised Fair BaseRate ($30,775) and 7.9× 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) For-Profit / Non-501(c)(3)

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

EIN: 824194264

Filing Period: 201906

Public IRS & CMS ownership records classify Piedmont Walton Hospital as a non-501(c)(3) facility. Federal 26 U.S.C. § 501(r) statutory charity-care caps apply specifically to tax-exempt nonprofit hospitals, though state hospital fair-pricing statutes and prompt-pay self-pay discounts may still apply.

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 Composite67/100

Would Recommend66%

Rated 9 or 10 (HCAHPS)68%

Median ER Wait137 min

Left ER Before Seen0%

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

2025-08-21·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare (607 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

Higher-Quality, Above-Median Price Tier

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

Price Index: 1.72× regional baseline

Quality: 61/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

UnitedHealthcare

-41.1%

Kaiser Permanente

+74.2%

Median Household Income$82,381U.S. Census ACS

Local Uninsured Share11.5%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 89/100 · Verified CMS CCN 110046 EIN 824194264

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 110046) ↗ Verify IRS Form 990 (EIN 824194264) ↗ CMS HCRIS Cost Reports ↗

Published MRF File824194264_piedmont-walton-hospital_standardcharges.zip!824194264_piedmont-walton-hospital_standardcharges.csv

Publication / Vintage2026-07-01 · 65.05 MB

Validated Rate Rows1,727 (CMS v3.0.0)

File Integrity Digest346fc0872301d3d13070…

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