Macon Community Hospital
204 Medical Drive, Lafayette, TN 37083 · 79 Priced Procedures
Typical commercial prices here are +35% above the fair benchmark (1.35×) even after accounting for local nurse/doctor wages and patient complexity.
3-Star CMS clinical quality rating paired with 1.35× fair market pricing.
Loss-Leader / Captive Ancillary Cross-Subsidizer
Macon Community Hospital prices routine shoppable procedures near 1.5× Medicare (p50 1.31×) while skewing captive emergency, lab, and upper-quartile codes to 2.2× Medicare (p75 2.00×, +53% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.90× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 61% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (69/100 safety score) with 72% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (58.4% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.9× markup over Medicare rates
- Captive ER (1.1×) & laboratory (2.6×) services average 1.47× higher multiples than routine shoppable care (1.5×)
- Upper-quartile procedures (Q75 2.00×) jump +53% above the median procedure ratio (Q50 1.31×)
- Unnegotiated chargemaster list prices average 4.6× Medicare (31¢ true HCRIS cost per $1 gross)
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 Macon Community Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 79 published procedures.
Audit a Bill or Quote at Macon Community Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $2,377
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (58.4% of gross = $2,377).
Self-Pay Cash Rate ($2,442) Beats Your Bill
Macon Community Hospital's published 45 CFR § 180 self-pay cash rate is $2,442 (vs. $2,442 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $1,021 Fair BaseRate ($877 Medicare)
Your bill ($4,070) is $3,049 above the denoised Fair BaseRate ($1,021) and 4.6× the $877 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (58.4% 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
Source: CMS Hospital Care Compare. 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 Macon Community Hospital.
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.