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Short Term Acute Care HospitalVoluntary Non-Profit - Private

Hamilton Medical Center

Hamilton Health Care System · Dalton, GA

1200 Memorial Drive, Dalton, GA 30720(706) 272-6105

3 of 5

CMS star rating

243

Beds

10,500

Inpatient discharges a year

$434.3M

Net patient revenue a year

33

In-network payers

About this hospital

Hamilton Medical Center is a 243-bed voluntary non-profit - private hospital in Dalton, GA, affiliated with Hamilton Health Care System. Below you'll find publicly disclosed negotiated rates and facility details, including 33 in-network payers and 337 disclosed rate categories.

  • Rural referral center
  • Reclassified as rural
  • Disproportionate share hospital
  • 340B participant
  • ACO participant
  • Helipad
CCN
110001
NPI
1528056066
Health system
Hamilton Health Care System
Teaching
Teaching hospital
County
Whitfield County
Metro area
Dalton, GA MSA
Medicare contractor
Jurisdiction J, Palmetto GBA (10001)
In Medicare since
1966
Last CMS survey
2025

Prices for common services

The 24 services Hamilton Medical Center most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.

Book a demo to see hidden insurer names, more payer rates, and hospital data, or start a free trial.

Childbirth · Inpatient

Vaginal delivery, hospital stay

MS-DRG 807

$13,465 - $18,054

from 2 insurers · median $15,760

Cigna$18,054
Insurer A*$13,465

CMS lists this service as CPT 59400, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.

Hospital reports neonatal nursery services to CMS

Childbirth · Inpatient

Cesarean delivery, hospital stay

MS-DRG 788

$18,960 - $24,324

from 2 insurers · median $21,642

Cigna$24,324
Insurer A*$18,960

CMS lists this service as CPT 59510, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 788, so these are facility case rates.

Hospital reports neonatal nursery services to CMS

Digestive procedures

Upper GI endoscopy with biopsy

CPT 43239

$5,392 - $7,802

from 2 insurers · median $6,597

Aetna$7,802
Insurer A*$5,392
Medicare $869Nearby hospitals $3,80074% above nearby hospitals

Common here, based on CMS Medicare volume

Digestive procedures

Colonoscopy with polyp removal

CPT 45385

$3,040 - $7,810

from 3 insurers · median $5,392

Aetna$7,810
Insurer A*$3,040
Insurer B*$5,392
Medicare $1,147Nearby hospitals $2,190146% above nearby hospitals

Common here, based on CMS Medicare volume

How the insurers pay at Hamilton Medical Center

Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.

InsurerServicesMedian % of MedicareAbove nearbyBelow nearby
Insurer A*20
562%
190
Insurer B*5
497%
50
Insurer C*16
304%
130
Insurer D*7
249%
40

How we chose these services: 6 appear in this hospital's own Medicare claims, 12 are common here based on CMS Medicare volume, and 6 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Hamilton Medical Center, or start a free trial.

Insurance Accepted

Acceptance varies by plan and service. Confirm coverage with your insurer or the hospital's billing department.

Medicare
Aetna
BCBS
Cigna
United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health)
Alliant Health PlansAmeri HealthAspirus Health PlanAvera Health PlansBanner HealthCentene

More about this hospital

  • Quality

    3 of 5 stars

    • 181 min in the ER before going home (US median 148)
    • Medicare readmissions penalty (-0.31%)
    See quality ratings
  • Doctors and services

    Accredited by The Joint Commission

    • Teaching hospital
    • 28 services
    • 487 affiliated clinicians
    See doctors and services
  • Finances

    $434.3M net patient revenue

    • Operating margin on patient care 7.5%
    • $27.1M unreimbursed and uncompensated care
    • $89.2M net income
    See finances
  • Ownership and leadership

    Owned by Hamilton Medical Center, Inc

    • Private (not for profit)
    • Jeffrey D Myers, chief executive
    • 340B drug pricing program participant
    See ownership and leadership

Tax IDs and NPIs insurers list

The employer identification numbers (EINs) health plans and networks list for Hamilton Medical Center in the in-network rate files they publish, with the organization NPIs billed under each.

Tax ID (EIN)Plans and networks listing itOrganization NPIs
58-1519911(multi-state) Hamilton Medical Center53Aetna, Cigna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), Alliant Health Plans, Allied Benefit Systems and 48 more1528056066 Hamilton Medical Center Inc.1588652739 Hamilton Medical Center Inc1861480188 Hamilton Medical Center Incand 5 more

Source: PayerPrice analysis of insurers' Transparency in Coverage in-network files. An EIN can cover several hospitals and clinics in a health system, and insurers sometimes list other organizations' NPIs under it.

Location

1200 Memorial Drive, Dalton, GA 30720

(706) 272-6105

Get directions

Frequently asked questions

About Hamilton Medical Center's rates and hospital price transparency.

How much does an MRI cost at Hamilton Medical Center?

For MRI of the brain, without contrast (CPT 70551), published negotiated rates at Hamilton Medical Center range from $1,211 to $1,895 across 2 insurers. Blue Cross Blue Shield's rate is $1,211. The median at nearby comparable hospitals is $406. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does a CT scan cost at Hamilton Medical Center?

For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Hamilton Medical Center range from $796 to $1,365 across 2 insurers. Blue Cross Blue Shield's rate is $796. The median at nearby comparable hospitals is $611. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does a colonoscopy cost at Hamilton Medical Center?

For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Hamilton Medical Center range from $3,040 to $7,810 across 3 insurers. Aetna's rate is $7,810. The median at nearby comparable hospitals is $2,190. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does giving birth cost at Hamilton Medical Center?

For Vaginal delivery, hospital stay (MS-DRG 807), published negotiated rates at Hamilton Medical Center range from $13,465 to $18,054 across 2 insurers. Cigna's rate is $18,054. What a patient pays depends on their plan's deductible, coinsurance and network status.

How much does a mammogram cost at Hamilton Medical Center?

For Screening mammography, bilateral (CPT 77067), published negotiated rates at Hamilton Medical Center range from $271 to $568 across 2 insurers. Cigna's rate is $271. The median at nearby comparable hospitals is $181. What a patient pays depends on their plan's deductible, coinsurance and network status.

What is Hamilton Medical Center's CMS star rating?

Hamilton Medical Center has a CMS overall hospital star rating of 3 out of 5 on Medicare Care Compare (CMS data released 2026-08-13). That is lower than 42% of US hospitals.

Is Hamilton Medical Center a teaching hospital?

Yes. CMS counts 0.20 Medicare-funded residents per bed at Hamilton Medical Center for fiscal year 2027, so it is a teaching hospital.

Does Medicare penalize Hamilton Medical Center for readmissions?

Yes. Under the Hospital Readmissions Reduction Program, Medicare cuts Hamilton Medical Center's base inpatient payments by an estimated 0.31% in fiscal year 2027 for more readmissions than expected.

What are the most common Medicare inpatient stays at Hamilton Medical Center?

In 2024, the most common were heart failure and shock with mcc (198 discharges), simple pneumonia and pleurisy with mcc (124 discharges), septicemia or severe sepsis without mv >96 hours with mcc (121 discharges).

What is Hamilton Medical Center's case mix index?

Hamilton Medical Center's Medicare case mix index is 1.72 for fiscal year 2027, higher than 54% of hospitals paid under the inpatient prospective payment system.

For hospital finance and compliance teams

Running price transparency at a hospital like this one?

The data on this page comes from the files hospitals and payers publish. We help hospitals publish theirs correctly, and take a fresh look at their chargemaster.

Compliance MRF

Publish a CMS-compliant machine-readable file

We turn your chargemaster and payer contracts into the CMS template file, then keep it current as rates change.

CMS v3 example: standard_charge_information[0]
{
  "description": "MRI of brain (no contrast)",
  "code_information": [
    { "code": "611", "type": "RC" },
    { "code": "70551", "type": "CPT" }
  ],
  "standard_charges": [{
    "setting": "outpatient",
    "minimum": 250,
    "maximum": 400,
    "gross_charge": 1200,
    "discounted_cash": 1080,
    "payers_information": [
      {
        "payer_name": "Platform Health Insurance",
        "plan_name": "PPO",
        "methodology": "fee schedule",
        "standard_charge_dollar": 400
      },
      {
        "payer_name": "Region Health Insurance",
        "plan_name": "HMO",
        "methodology": "fee schedule",
        "standard_charge_dollar": 250
      }
    ]
  }]
}
  • CMS template layout, in JSON or CSV
  • Gross, discounted cash, payer-specific and de-identified min / max charges
  • cms-hpt.txt file and homepage footer link
  • Refreshed when your contracts change
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Chargemaster analysis

Get your chargemaster right for billing and payer contracts

Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.

What a review covers

CodingPricingPayer contractsCompliance
  • CPT, HCPCS, revenue code and modifier errors flagged line by line
  • Missing, duplicate and outdated charge lines identified
  • Charges set below payer allowables caught before lesser-of clauses cut payment
  • Revenue impact of charge changes modeled across percent-of-charge and stop-loss terms
  • Your negotiated rates benchmarked against peer hospitals for the same payers
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