Cost Comparison Tool
Cost Comparison Tool
Disclaimer: The cost estimates provided on the Cost Comparison Tool for specific healthcare services and procedures represent median costs to facilitate comparison between healthcare providers and do not reflect what an individual's out-of-pocket costs may be for any given procedure. Please contact your health insurance company or your provider to get a personalized estimate.
Introduction
The Cost Comparison Tool provides costs for common medical procedures, by allowing users to:
- Enter a zip code of interest
- Set a distance to search for facilities
- Specify payer/insurance type (or see all payers)
- Select medical procedures of interest
- Specify cost type (professional or facility)
The dashboard then shows median costs and a cost range (25th to 75th percentile) by facility for the selections, along with a statewide median cost and a map of facilities. If available, an overall quality rating for the facility will be displayed based on data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, which is not specific to the procedure. The Cost Comparison Tool is designed for use on full-screen devices. See Methods and Limitations below for additional information on filters and metrics.
Cost Comparison Tool
The Cost Comparison Tool is designed to show the costs of specific medical procedures across Georgia based on insurance claims data.
Methods
Median Cost
Median costs are shown at the facility level in the map and in the main chart; statewide median cost is show in the upper right corner of the dashboard and as a dotted line in the main chart. Cost reflects the sum of medical claims costs, including both payer and patient paid amounts in the selected stratification (e.g. for a given medical procedure, payer/insurance type, cost type). Claims with similar procedure codes were grouped together in calculating median costs (specific procedure codes or diagnosis-related groups are also shown on the dashboard). Costs are from claims with service dates in 2023 and 2024; denied claims and “orphaned” adjustments were excluded along with claims that fell outside of the 5th and 95th percentile of costs for a given procedure and cost type.
25th and 75th Percentile Cost Range
In addition to median costs, which are shown as a yellow square in the main chart, the 25th and 75th percentile of costs are shown by facility in the green bar. All specifications for median costs also apply to calculation of the cost range.
Facility Identification
Not all facilities in the APCD were included in this dashboard. A list of hospital and non-hospital facilities were sourced from the Centers for Medicare & Medicaid Services’ Provider of Service (POS) files as of September 2025 (https://data.cms.gov/provider-characteristics). Facilities from claims were compared to facilities from the POS list and only those with matching CMS Certification Number (CCN) (based on a CCN-National Provider Identifier crosswalk) or matching provider name and zip code were included.
Distance
Users can filter facilities based on the distance from the zip code of interest entered in the filters panel. Distance is calculated based on the straight-line distance between the centroids of the user-entered and facility zip codes. The chart displays the distance for the given facility.
Patient Count
When hovering over the cost information for a facility, a tooltip appears to give more information on the facility, including patient count. The patient count represents the total number of patients who received that procedure at that facility across 2023 and 2024, limited by the selected stratification (e.g. for a given payer/insurance type and cost type).
Facility Rating
Rating scores shown are from the 2023 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey (https://www.cms.gov/medicare/quality/initiatives/hospital-quality-initi…). This standardized survey gathers patient feedback on different parts of their hospital experience. The rating reflects the opinion of patients on the quality of care they received at this facility. However, the patients who answered the survey are not necessarily the same patients whose costs are shown; those patients are from claims, a different data source. The ratings are not specific to the procedures selected but are for the overall facility.
Payer
Users can filter based on payer or insurance type, specifically Commercial, Medicaid, and Medicare (only Medicare Advantage currently), which are assigned based on the submitter and plan type on the claim. At this time, users cannot select specific insurance companies as payers. There is also an "All Payers" option to view costs across all payers.
Cost Type
Users can filter based on professional (e.g. from physicians, nurse practitioners, other individual providers) or facility (e.g. from hospitals and other institutions) costs. Some procedures or DRGs only have costs of a certain type and some have both types. Note that costs are attributed to a facility only if it meets the facility identification method above. For professional services in particular, individual providers may bill separately under their own name or NPI and would not be attributed to a specific facility in the dashboard.
Caveats and Limitations
Missing Data
This Snapshot is based on data present in the Georgia All-Payer Claims Database as of June 2025 with service dates in 2023 and 2024. The GA APCD as of June 2025 does not include Medicare Fee-for-Service data, Elevance data, and self-insured payers. Metrics may thus change in subsequent releases as these data and additional historical data are added.
Data Suppression and De-Identification
Aggregations with patient counts less than 11 are suppressed and will not be included in dashboards. APCD data is de-identified, used, and disclosed with guidance from the US Department of Health and Human Services in accordance with section 164.514(a) of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule.
Questions
If you have any questions about the Cost Comparison Tool, email us at [email protected].