Sgmc Health Lanier
116 West Thigpen Avenue, Lakeland, GA 31635 · 58 Priced Procedures · 80% Patient Recommendation
Typical commercial prices here are 13% below the fair benchmark (0.87×) after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Uniform Value Leader · Low-Cost Across Departments
Sgmc Health Lanier maintains low, disciplined commercial pricing across both routine shoppable procedures (0.9× Medicare, p50 0.85× Fair BaseRate) and emergency/ancillary services (1.0× Medicare, p75 1.00× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.
Where They're Good (Patient & Payer Edge)
- Elective shoppable care is priced 13% below peer Fair BaseRate (0.87×)
- Self-pay cash beats commercial insurance on 4% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (72/100 safety score) with 80% patient recommendation
- Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (0.87× 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.
- Captive ER (0.5×) & laboratory (1.3×) services average 1.11× higher multiples than routine shoppable care (0.9×)
- Upper-quartile procedures (Q75 1.00×) jump +18% above the median procedure ratio (Q50 0.85×)
- Consolidated metro market (HHI 6,748) 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 Sgmc Health Lanier
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 58 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Rabies immune globulin HCPCS Code: 90375 | $2,167 | 6.7× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $488 | 0.8× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $312 | 0.7× |
| Hepatitis B immune globulin HCPCS Code: 90371 | $237 | 1.6× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $213 | 0.8× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $213 | 0.7× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $157 | 0.6× |
| X-ray, pelvis CPT Code: 72170 | $93 | 0.8× |
| X-ray, lower back CPT Code: 72110 | $93 | 0.8× |
| Ultrasound, abdomen (limited) CPT Code: 76705 | $93 | 0.7× |
| Ultrasound, pelvis CPT Code: 76856 | $93 | 0.7× |
| Ultrasound, thyroid and neck CPT Code: 76536 | $93 | 0.7× |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $93 | 0.7× |
| CT scan, head (no contrast) CPT Code: 70450 | $93 | 0.6× |
| CT scan, pelvis CPT Code: 72192 | $93 | 0.6× |
| CT scan, sinuses CPT Code: 70486 | $93 | 0.6× |
| CT scan, chest (no contrast) CPT Code: 71250 | $93 | 0.6× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $93 | 0.6× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $93 | 0.6× |
| Typhoid vaccine HCPCS Code: 90675 | $1,175 | 3.4× |
| Pneumococcal vaccine HCPCS Code: 90732 | $253 | 1.8× |
| Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: 90715 | $166 | 3.0× |
| Hepatitis B vaccine HCPCS Code: 90744 | $64 | 1.7× |
| X-ray, chest (single view) CPT Code: 71045 | $78 | 0.8× |
| X-ray, shoulder CPT Code: 73030 | $78 | 0.8× |
Audit a Bill or Quote at Sgmc Health Lanier (Zero PHI Required)
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.
Self-Pay Cash Rate ($2,167) Beats Your Bill
Sgmc Health Lanier's published 45 CFR § 180 self-pay cash rate is $2,167 (vs. $2,167 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $322 Fair BaseRate ($275 Medicare)
Your bill ($2,889) is $2,567 above the denoised Fair BaseRate ($322) and 10.5× the $275 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Public IRS & CMS ownership records classify Sgmc Health Lanier 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.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)Source: CMS Hospital Care Compare (50 completed HCAHPS patient surveys). 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 Sgmc Health Lanier.
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.