Gadsden Regional Medical Center
GADSDEN REGIONAL MEDICAL CENTER in Gadsden, Alabama charges 20.4x the Medicare reimbursement rate across 38 analyzed procedures, with 95% showing significantly elevated pricing patterns.
Gadsden, AL 35903 · Acute Care Hospitals · CMS Rating: 1/5
About the analyst
Kevin Nyk analyzes hospital pricing data at BillRazor Research. He specializes in Medicare reimbursement patterns and chargemaster pricing across U.S. hospitals. Expertise: hospital pricing, Medicare rates, chargemaster analysis.
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Billing patterns — for-profit
For-profit hospitals in our dataset demonstrate distinct billing patterns, with 628 facilities showing an average markup of 7.8 times Medicare rates. These hospitals typically maintain higher charge structures across most service categories compared to non-profit and government facilities. Common patterns include substantial charges above benchmark rates for emergency services, surgical procedures, and diagnostic imaging. Patients should be aware that initial bills from for-profit hospitals often reflect chargemaster rates rather than negotiated insurance amounts. The billing structure frequently includes separate charges for facility fees, physician services, and ancillary services that may appear as multiple line items. Before receiving care, patients can request cost estimates and inquire about financial assistance programs, which are federally required at all hospital types. Understanding that insurance negotiations typically result in significantly lower actual payments than initial charges can help patients navigate the billing process more effectively when receiving care at for-profit facilities.
Pricing grade
F
Very high
Avg markup vs Medicare
20.43x
Charge / Medicare rate
Max markup
28.08x
Worst procedure
Procedures analyzed
38
With pricing data
Outlier procedures
94.7%
Above 90th percentile
Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.
| Procedure | Code | Gross charge | Cash price | Medicare | Markup |
|---|---|---|---|---|---|
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $95,702 | $47,851 | — | 28.1x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $139,134 | $69,567 | — | 27.7x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $197,702 | $98,851 | — | 27.5x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $118,008 | $59,004 | — | 26x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $127,854 | $63,927 | — | 25.5x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $152,205 | $76,102 | — | 25.3x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $284,017 | $142,008 | — | 24.9x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $131,067 | $65,533 | — | 24.9x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $87,218 | $43,609 | — | 24x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $96,049 | $48,024 | — | 23x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $177,837 | $88,919 | — | 23x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $134,909 | $67,455 | — | 21.8x |
| CELLULITIS WITHOUT MCC | 603 | $88,838 | $44,419 | — | 21.5x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $91,605 | $45,802 | — | 21.4x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $83,370 | $41,685 | — | 21.1x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $151,616 | $75,808 | — | 21x |
| SEIZURES WITH MCC | 100 | $159,585 | $79,793 | — | 20.5x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $200,728 | $100,364 | — | 20.2x |
| SYNCOPE AND COLLAPSE | 312 | $96,588 | $48,294 | — | 20x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $145,611 | $72,806 | — | 19.9x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $214,294 | $107,147 | — | 19.7x |
| DIABETES WITH CC | 638 | $88,004 | $44,002 | — | 19.3x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $169,975 | $84,987 | — | 18.9x |
| CHEST PAIN | 313 | $75,447 | $37,723 | — | 18.9x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $109,165 | $54,582 | — | 18.8x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $194,709 | $97,354 | — | 18.6x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $116,534 | $58,267 | — | 18.6x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $199,330 | $99,665 | — | 18.2x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $91,762 | $45,881 | — | 18.1x |
| RENAL FAILURE WITH CC | 683 | $85,690 | $42,845 | — | 17.6x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $179,926 | $89,963 | — | 17.2x |
| RENAL FAILURE WITH MCC | 682 | $136,998 | $68,499 | — | 16.8x |
| SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | 870 | $655,268 | $327,634 | — | 16.8x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $86,083 | $43,042 | — | 16x |
| PSYCHOSES | 885 | $115,829 | $57,914 | — | 15.6x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $106,066 | $53,033 | — | 14.6x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $412,748 | $206,374 | — | 14.2x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $103,643 | $51,821 | — | 12x |
How GADSDEN REGIONAL MEDICAL CENTER compares to nearby hospitals
Comparison based on average markup ratios from federal hospital pricing data (FY 2024). Chargemaster rates are gross charges — they are not what most insured patients pay. Actual costs depend on your insurance plan, negotiated rates, and coverage terms. This comparison is for informational purposes only and does not constitute medical, financial, or legal advice. Verify costs directly with your provider and insurer.
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Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.
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Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.
Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use