CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Tristar Skyline Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $253
Cash Discount Price: $670
vs. Medicare Baseline: 2.15x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Tristar Skyline Medical Center is $253. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $670. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 2.15x the Medicare baseline. Located in 3441 Dickerson Pike, Nashville, TN.

Cash / Self-Pay

$670

Average discount available for prompt cash payment at this facility.

Insurance Median

$253

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$117.57

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $117.57 (100%)

Cash / Self-Pay: $670 (570%)

Insurance Median: $253 (215%)

Cash: $670 (570% of Medicare)

Ins. Median: $253 (215% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $117.57 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 215% of the Medicare baseline (a markup of 115%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

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

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$76 - $417	65%
Blue Cross Blue Shield	$82 - $163	70%
Oscar	$92 - $153	78%
Kentucky Labor Cabinet	$93 - $154	79%
Nhc Advantage, Inc.	$96 - $159	82%
Pruitt Health (Allyalign)	$96 - $159	82%
United	$125 - $376	106%
Humana	$126 - $543	107%
Centurion	$208 - $344	177%
Bgfh Singlesource	$253 - $710	215%
Signature Advantage	$253 - $417	215%
Employers Health Network	$354 - $584	301%
Mhnet	$379 - $626	322%
Odom'S Tn Pride Sausage	$379 - $626	322%
Multiplan	$414 - $685	352%
Beech Street	$444 - $735	378%
Prime Health	$444 - $735	378%
Triwest Healthcare	$495 - $818	421%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $670.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99203.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Tristar Skyline Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99203.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.