How many shoppable procedure prices are published for Stephens County Hospital?

Stephens County Hospital in Toccoa, GA currently has 97 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Stephens County Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Stephens County Hospital's median negotiated commercial rate is 1.0× the regionally adjusted fair BaseRate benchmark.

What is Stephens County Hospital's CMS Care Compare overall star rating?

CMS Care Compare assigns Stephens County Hospital an overall hospital quality rating of 2 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Government - Hospital District or Authority 40 Beds · rural Updated: 2026-05-19

Stephens County Hospital

163 Hospital Drive, Toccoa, GA 30577 · 97 Priced Procedures · 74% Patient Recommendation

CMS Overall Rating 2 / 5 Stars

Near Fair BaseRate Benchmark

1.03×vs. Fair Market Price

Typical commercial prices here are +3% above the fair benchmark (1.03×) even after accounting for local nurse/doctor wages and patient complexity.

83/100 · Corroborated

83/100Self-Pay Cash Beats Insurance 85% of the Time

File Completeness95

Price Logic69

Peer Alignment68

Clean Billing89

Real Cash Discount100

Regional Value Leader

4-Star CMS clinical quality rating paired with 1.03× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Stephens County Hospital prices shoppable and inpatient services (1.6× to 1.1× Medicare, divergence 0.69×) in alignment with regional hospital peers (1.03× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#40 of 100 in GA · 39th State Percentile#1,414 of 3,385 in U.S. · 41st National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.86× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 85% of shoppable procedures (99/100 Cash Honesty)
2-Star CMS clinical rating with 74% patient recommendation (74/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (40.5% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.2× markup over Medicare rates
Commercial insurance median sits at 1.01× Fair BaseRate (1.6× Medicare), so insured patients should always compare the self-pay cash price before paying.
Specialty infusion drugs (J-codes) average 1.4× Medicare — verify per-unit billing on itemized statements
Consolidated metro market (HHI 10,000) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.6× Medicare

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

Back-Door Captive & ER0.69× Divergence

1.1× Medicare

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

Quantile Tail Spread+13% Upper Tail

Q25 0.86× · Q50 1.01× · Q75 1.14×

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

1.6× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.2× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.4× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.1× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.9× MedicareGood

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

1.4× MedicareGood

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

85% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

2 CMS · 74/100Fair

Procedure Prices at Stephens County Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 97 published procedures.

Sort:

Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Total hip replacement CPT Code: `27130`	$28,800	$48,000	$13,413	unverified
Gallbladder removal (laparoscopic) CPT Code: `47562`	$12,510	$20,850	$6,109	3.4×
Breast lump removal CPT Code: `19120`	$8,250	$13,750	$3,875	unverified
Knee arthroscopy with meniscus repair CPT Code: `29881`	$7,800	$13,000	$3,372	unverified
Bunion correction surgery CPT Code: `28296`	$7,155	$11,925	$3,446	3.5×
Cataract surgery with lens implant CPT Code: `66984`	$3,033	$5,055	$2,540	2.0×
Sleep study (overnight, in lab) CPT Code: `95810`	$1,519	$990	$1,021	1.0×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$679	$534	$583	0.9×
Blood transfusion CPT Code: `36430`	$476	$425	$498	0.9×
New patient office visit (30-44 min) CPT Code: `99203`	$229	$381	$110	3.5×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,334	$348	$448	0.8×
MRI, brain (with and without contrast) CPT Code: `70553`	$850	$348	$511	0.7×
Office visit, established patient (20-29 min) CPT Code: `99213`	$169	$281	$87	3.2×
Office visit, established patient (30-39 min) CPT Code: `99214`	$183	$305	$123	2.5×
Rabies immune globulin HCPCS Code: `90375`	$3,475	$280	$322	0.9×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$469	$235	$272	0.9×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$866	$235	$303	0.8×
MRI, lower back (no contrast) CPT Code: `72148`	$470	$235	$338	0.7×
MRI, brain (no contrast) CPT Code: `70551`	$509	$235	$343	0.7×
MRI, knee or other leg joint CPT Code: `73721`	$930	$235	$369	0.6×
Breathing treatment (nebulizer) CPT Code: `94640`	$174	$198	$201	1.0×
Diagnostic procedure preparation HCPCS Code: `G0279`	$125	$208	$35	unverified
CT scan, head (with contrast) CPT Code: `70460`	$512	$173	$242	0.7×
CT scan, head (with and without contrast) CPT Code: `70470`	$668	$173	$258	0.7×
Speech therapy (language evaluation) CPT Code: `92507`	$159	$159	$86	unverified
Speech therapy (group session) CPT Code: `92508`	$48	$81	$27	3.0×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$54	$90	$38	2.4×
Physical therapy (functional capacity test) CPT Code: `97750`	$54	$90	$38	2.4×
Occupational therapy (self-care training) CPT Code: `97535`	$51	$85	$38	2.2×
Prosthetic fitting and training CPT Code: `97761`	$55	$91	$45	2.0×
Hospital observation (per hour) HCPCS Code: `G0378`	$51	$84	$86	1.0×
X-ray, pelvis CPT Code: `72170`	$80	$103	$110	0.9×
X-ray, chest (single view) CPT Code: `71045`	$80	$86	$92	0.9×
X-ray, shoulder CPT Code: `73030`	$138	$86	$92	0.9×
X-ray, foot CPT Code: `73630`	$106	$86	$92	0.9×
X-ray, chest (two views) CPT Code: `71046`	$96	$86	$93	0.9×
X-ray, neck (cervical spine) CPT Code: `72040`	$111	$86	$93	0.9×
X-ray, hand CPT Code: `73130`	$88	$86	$93	0.9×
X-ray, hip CPT Code: `73502`	$70	$86	$93	0.9×
X-ray, ankle CPT Code: `73610`	$109	$86	$93	0.9×
X-ray, lower back CPT Code: `72110`	$209	$103	$112	0.9×
Ultrasound, abdomen (limited) CPT Code: `76705`	$325	$103	$126	0.8×
Ultrasound, pelvis CPT Code: `76856`	$435	$103	$130	0.8×
Ultrasound, thyroid and neck CPT Code: `76536`	$293	$103	$132	0.8×
Ultrasound, abdomen (complete) CPT Code: `76700`	$433	$103	$134	0.8×
CT scan, head (no contrast) CPT Code: `70450`	$398	$103	$160	0.6×
CT scan, pelvis CPT Code: `72192`	$398	$103	$163	0.6×
CT scan, sinuses CPT Code: `70486`	$533	$103	$166	0.6×
CT scan, chest (no contrast) CPT Code: `71250`	$398	$103	$167	0.6×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$448	$103	$168	0.6×
CT scan, neck (cervical spine) CPT Code: `72125`	$840	$103	$169	0.6×
Physical therapy (manual therapy) CPT Code: `97140`	$55	$91	$34	unverified
Typhoid vaccine HCPCS Code: `90675`	$601	$328	$347	0.9×
Pneumococcal vaccine HCPCS Code: `90732`	$100	$133	$140	0.9×
Physical therapy (gait training) CPT Code: `97116`	$36	$60	$33	1.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$38	$63	$35	1.8×
Orthotic fitting and training CPT Code: `97760`	$46	$77	$51	1.5×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$22	$23	$20	1.1×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$27	$44	$40	1.1×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$39	$58	$56	1.0×
Flu vaccine injection HCPCS Code: `G0008`	$72	$45	$48	0.9×
Pneumonia vaccine injection HCPCS Code: `G0009`	$45	$45	$49	0.9×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$94	$58	$64	0.9×
Screening mammogram (both breasts) CPT Code: `77067`	$76	$76	$123	0.6×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$65	$65	$148	0.4×
Electrical stimulation therapy HCPCS Code: `G0283`	$62	$62	$14	unverified
Urinalysis (automated, with microscopy) CPT Code: `81001`	$15	$4	$3	1.3×
Blood test, basic metabolic panel CPT Code: `80048`	$21	$10	$9	1.1×
Blood test, vitamin D CPT Code: `82306`	$32	$34	$31	1.1×
Blood test, calcium CPT Code: `82310`	$18	$6	$5	1.2×
Blood test, creatinine (kidney) CPT Code: `82565`	$21	$6	$5	1.2×
Blood test, clotting time (PTT) CPT Code: `85730`	$37	$7	$6	1.2×
Blood test, ferritin (iron stores) CPT Code: `82728`	$30	$16	$14	1.1×
Blood test, lipase CPT Code: `83690`	$30	$8	$7	1.1×
Blood test, magnesium CPT Code: `83735`	$26	$8	$7	1.1×
Blood test, complete blood count (CBC) CPT Code: `85025`	$29	$9	$8	1.1×
Culture, bacterial CPT Code: `87070`	$21	$10	$9	1.1×
Blood test, PSA (prostate screen) CPT Code: `84153`	$49	$21	$19	1.1×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$18	$11	$10	1.1×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$36	$12	$11	1.1×
Culture, blood CPT Code: `87040`	$22	$12	$11	1.1×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$18	$15	$14	1.1×
Blood test, vitamin B12 CPT Code: `82607`	$64	$17	$16	1.1×
Blood test, thyroid (TSH) CPT Code: `84443`	$25	$19	$18	1.1×
Blood test, liver function panel CPT Code: `80076`	$32	$9	$9	1.0×
Blood antibody screen CPT Code: `86850`	$59	$34	$46	0.7×
Blood test, amylase CPT Code: `82150`	$36	$7	$7	1.0×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$32	$32	$111	0.3×
Blood test, glucose (blood sugar) CPT Code: `82947`	$17	$4	$4	1.0×
Blood test, potassium CPT Code: `84132`	$9	$5	$5	1.0×
Blood test, sodium CPT Code: `84295`	$9	$5	$5	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$18	$4	$4	1.0×
Blood test, hemoglobin CPT Code: `85018`	$9	$3	$3	1.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$25	$5	$5	1.0×
Flu vaccine (high dose) HCPCS Code: `90656`	$24	$25	$25	1.0×
Hepatitis C antibody test CPT Code: `86803`	$52	$12	$15	0.8×
Hepatitis B vaccine HCPCS Code: `90744`	$14	$24	$37	0.6×

Showing top 25 high-impact procedures of 97 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 40.5%

Audit a Bill or Quote at Stephens County Hospital (Zero PHI Required)

CMS CCN: 110032

CPT 27130

Select Procedure to Audit:

Fair BaseRate™ $13,413

Medicare Rate $13,117

Self-Pay Cash $28,800

Insurer Median $48,000

1. Amount on Your Bill or Quote ($) Pre-filled with Stephens County 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: $19,426 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $19,426

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (40.5% of gross = $19,426).

Step 2 · Cash vs. Insurance Arbitrage Save $19,200 Paying Cash

Self-Pay Cash Rate ($28,800) Beats Your Bill

Stephens County Hospital's published 45 CFR § 180 self-pay cash rate is $28,800 (vs. $48,000 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$34,587 Above Fair BaseRate

Negotiate Toward $13,413 Fair BaseRate ($13,117 Medicare)

Your bill ($48,000) is $34,587 above the denoised Fair BaseRate ($13,413) and 3.7× the $13,117 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: 586001667

Filing Period: 194509

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 (40.5% 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 Overall4/5 Stars (4/5)

Safety Composite74/100

Would Recommend74%

Rated 9 or 10 (HCAHPS)72%

Median ER Wait124 min

Left ER Before Seen1%

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)

C. diff Hospital-Onset Infectionsame

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Stephens County Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2026-03-11·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (270 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 Stephens County Hospital.

Price Index: 1.00× regional baseline

Quality: 69/100 CMS composite

Median Household Income$52,264U.S. Census ACS

Local Uninsured Share13.5%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 83/100 · Corroborated CMS CCN 110032 EIN 586001667

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 110032) ↗ Verify IRS Form 990 (EIN 586001667) ↗ CMS HCRIS Cost Reports ↗

Published MRF File586001667_stephens-county-hospital_standardcharges.csv

Publication / Vintage2026-05-19 · 17.02 MB

Validated Rate Rows2,249 (CMS v3.0.0)

File Integrity Digest8fc54d58f633737fd7a9…

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