Erlanger Medical Center
975 E 3Rd St, Chattanooga, TN 37403 · 128 Priced Procedures · 65% Patient Recommendation
Typical commercial prices here are 10% below the fair benchmark (0.90×) after accounting for local nurse/doctor wages and patient complexity.
3-Star CMS clinical quality rating paired with 0.90× fair market pricing.
Uniform Value Leader · Low-Cost Across Departments
Erlanger Medical Center maintains low, disciplined commercial pricing across both routine shoppable procedures (0.9× Medicare, p50 0.92× Fair BaseRate) and emergency/ancillary services (1.0× Medicare, p75 1.03× 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 10% below peer Fair BaseRate (0.90×)
- Self-pay cash beats commercial insurance on 41% of shoppable procedures (99/100 Cash Honesty)
- 4-Star CMS clinical rating with 65% patient recommendation (69/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (37.2% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.1× markup over Medicare rates
- Captive ER (1.3×) & laboratory (1.7×) services average 1.11× higher multiples than routine shoppable care (0.9×)
- Specialty infusion drugs (J-codes) average 1.1× Medicare — verify per-unit billing on itemized statements
- Consolidated metro market (HHI 3,025) 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 Erlanger Medical Center
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 128 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $35,244 | unverified |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $17,296 | 0.9× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $16,723 | 0.9× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $16,152 | 0.9× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $8,204 | 1.0× |
| C-section delivery (full package) CPT Code: 59510 | $3,497 | unverified |
| Vaginal delivery (full package) CPT Code: 59400 | $3,123 | unverified |
| Total hip replacement CPT Code: 27130 | $2,255 | 0.2× |
| Total knee replacement CPT Code: 27447 | $2,253 | 0.2× |
| Trauma team activation HCPCS Code: G0390 | $1,250 | 0.9× |
| Blood transfusion CPT Code: 36430 | $1,219 | 2.4× |
| Bunion correction surgery CPT Code: 28296 | $1,170 | 0.3× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $1,118 | 0.2× |
| Cataract surgery with lens implant CPT Code: 66984 | $915 | 0.4× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $922 | 0.3× |
| Inguinal hernia repair CPT Code: 49505 | $883 | 0.2× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $761 | 0.7× |
| Breast lump removal CPT Code: 19120 | $751 | 0.2× |
| Injection procedure for pain management HCPCS Code: G0260 | $657 | 0.8× |
| Colonoscopy with biopsy CPT Code: 45380 | $491 | 0.4× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $428 | 0.8× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $420 | 0.4× |
| Upper endoscopy with biopsy CPT Code: 43239 | $369 | 0.4× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $334 | 0.7× |
| Rabies immune globulin HCPCS Code: 90375 | $306 | 1.0× |
Audit a Bill or Quote at Erlanger Medical Center (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $31,432
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (37.2% of gross = $31,432).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Erlanger Medical Center's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)
Your bill ($84,586) is $53,811 above the denoised Fair BaseRate ($30,775) and 3.6× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (37.2% 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.
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 (776 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 Erlanger Medical Center.
Notable Payer Contract Outliers (SVD Matrix Anomalies)
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.