CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Highpoint Health-Sumner With Ascension Saint Thoma

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $5,427
  • Cash Discount Price: $7,944
  • vs. Medicare Baseline: 0.96x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Highpoint Health-Sumner With Ascension Saint Thoma is $5,427. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,944. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 0.96x the Medicare baseline. Located in 555 Hartsville Pike, Gallatin, TN.
Cash / Self-Pay
$7,944

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,427

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$5,675.87

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $5,675.87 (100%)
Cash / Self-Pay: $7,944 (140%)
Insurance Median: $5,427 (96%)
Cash: $7,944 (140% of Medicare)
Ins. Median: $5,427 (96% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $5,675.87 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Blue Cross Blue Shield $4,855 - $5,627 86%
UnitedHealthcare $5,071 - $12,873 89%
Tricare $5,199 - $5,469 92%
Amerigroup $5,269 93%
Humana $5,269 93%
Lifesynch $5,269 93%
Medicare (plans) $5,269 93%
Devoted Health $5,427 96%
Tennessee Rural Health Improvement Association $5,427 96%
Healthspring $5,533 97%
Signature Health $5,585 98%
Community Health Network $5,808 102%
Cigna $8,065 - $8,889 142%
Ambetter / Centene $10,689 188%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 555 Hartsville Pike, Gallatin, TN 37066
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals