Clayton, GA
28
In-network payers
286
Disclosed rate categories
25
Beds
Mountain Lakes Medical Center is a 25-bed proprietary hospital in Clayton, GA. Below you'll find publicly disclosed negotiated rates and facility details, including 28 in-network payers and 286 disclosed rate categories.
CCN (Medicare provider number)
111336
NPI
1326191180
Type
Critical Access Hospital
Ownership
Proprietary
Beds
25
Insurance acceptance may vary by specific plan, network status, and services required. Contact your insurance provider or the hospital's billing department to confirm coverage details.
The 24 services Mountain Lakes 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.
CT imaging
CPT 74177
$461 - $769
from 4 insurers · median $639
Typical for a hospital with this service line
Cardiology and vascular testing
CPT 93306
$230 - $1,262
from 4 insurers · median $1,085
Typical for a hospital with this service line
Digestive procedures
CPT 45385
$1,961 - $2,901
from 3 insurers · median $2,343
Typical for a hospital with this service line
CT imaging
CPT 71275
$619 - $1,994
from 4 insurers · median $1,271
Typical for a hospital with this service line
Digestive procedures
CPT 43239
$1,786 - $2,901
from 3 insurers · median $1,917
Typical for a hospital with this service line
Digestive procedures
CPT 45380
$1,878 - $2,901
from 3 insurers · median $2,343
Typical for a hospital with this service line
Medicine & Surgery
CPT 47562
$6,774 - $13,746
from 2 insurers · median $10,260
Typical for a hospital with this service line
Medicine & Surgery
CPT 66984
$4,035 - $6,995
from 4 insurers · median $5,172
Typical for a hospital with this service line
CT imaging
CPT 70450
$188 - $412
from 4 insurers · median $260
Typical for a hospital with this service line
Gynecology
CPT 58571
$4,641 - $13,746
from 2 insurers · median $9,193
Typical for a hospital with this service line
Digestive procedures
CPT 49650
$5,805 - $13,746
from 2 insurers · median $9,776
Typical for a hospital with this service line
Medicine & Surgery
CPT 42820
$2,101 - $14,025
from 4 insurers · median $9,273
Typical for a hospital with this service line
CT imaging
CPT 74176
$246 - $619
from 4 insurers · median $455
Typical for a hospital with this service line
MRI imaging
CPT 70553
$636 - $1,710
from 4 insurers · median $958
Typical for a hospital with this service line
Gynecology
CPT 58558
$2,155 - $7,570
from 4 insurers · median $6,615
Typical for a hospital with this service line
Gynecology
CPT 58661
$5,805 - $13,746
from 2 insurers · median $9,776
Typical for a hospital with this service line
Gynecology
CPT 58662
$5,805 - $13,746
from 2 insurers · median $9,776
Typical for a hospital with this service line
Laboratory and pathology
CPT 80053
$11 - $134
from 4 insurers · median $109
Typical for a hospital with this service line
Urology
CPT 50590
$6,583 - $13,746
from 2 insurers · median $10,165
Typical for a hospital with this service line
X-ray and bone density
CPT 71046
$35 - $179
from 4 insurers · median $94
Typical for a hospital with this service line
MRI imaging
CPT 72148
$560 - $871
from 4 insurers · median $748
Typical for a hospital with this service line
MRI imaging
CPT 70551
$560 - $843
from 4 insurers · median $712
Typical for a hospital with this service line
Medicine & Surgery
CPT 29881
$5,420 - $8,351
from 2 insurers · median $6,886
Typical for a hospital with this service line
Ear, nose and throat
CPT 69436
$2,200 - $3,647
from 4 insurers · median $2,952
Typical for a hospital with this service line
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.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 14 | 231% | 1 | 11 |
| Insurer B* | 24 | 223% | 1 | 9 |
| Insurer C* | 17 | 201% | 2 | 7 |
| Insurer D* | 24 | 157% | 2 | 7 |
How we chose these services: 0 appear in this hospital's own Medicare claims, 0 are common here based on CMS Medicare volume, and 24 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 Mountain Lakes Medical Center.
196 Ridgecrest Circle, Clayton, GA 30525
(706) 782-3100
The nearest hospitals of similar type and size. Their rates are compared with Mountain Lakes Medical Center for the same insurers and services above.
Highlands Cashiers Hospital
â–² Rates typically 286% higher than Mountain Lakes Medical Center (10 services)
Chatuge Regional Hospital
â–² Rates typically 49% higher than Mountain Lakes Medical Center (14 services)
Angel Medical Center
â–² Rates typically 103% higher than Mountain Lakes Medical Center (14 services)
Swain County Hospital
â–¼ Rates typically 50% lower than Mountain Lakes Medical Center (11 services)
Erlanger Western Carolina Hospital
â–¼ Rates typically 31% lower than Mountain Lakes Medical Center (24 services)
Transylvania Regional Hospital
â–² Rates typically 193% higher than Mountain Lakes Medical Center (12 services)
Bleckley Memorial Hospital
Early Medical Center
Elbert Memorial Hospital
About Mountain Lakes Medical Center's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Mountain Lakes Medical Center range from $636 to $1,710 across 4 insurers. Cigna's rate is $1,032. The median at nearby comparable hospitals is $2,632. What a patient pays depends on their plan's deductible, coinsurance and network status.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Mountain Lakes Medical Center range from $461 to $769 across 4 insurers. Aetna's rate is $619. The median at nearby comparable hospitals is $3,155. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Mountain Lakes Medical Center range from $1,961 to $2,901 across 3 insurers. Blue Cross Blue Shield's rate is $1,961. What a patient pays depends on their plan's deductible, coinsurance and network status.
Mountain Lakes Medical Center has 25 beds. Facility type: Critical Access Hospital.
Mountain Lakes Medical Center is located at 196 Ridgecrest Circle, Clayton, GA 30525. Its main phone number is (706) 782-3100.
Mountain Lakes Medical Center's CMS Certification Number (CCN), also called its Medicare provider number, is 111336.
The National Provider Identifier (NPI) on file for Mountain Lakes Medical Center is 1326191180.
Mountain Lakes Medical Center lists 28 in-network payers, including Aetna, Ambetter, Ameri Health, Aspirus Health Plan, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
286 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
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{
"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
}
]
}]
}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