CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Blount Memorial Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $5,310
Cash Discount Price: $6,128
vs. Medicare Baseline: 0.94x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Blount Memorial Hospital is $5,310. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,128. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 0.94x the Medicare baseline. Located in 907 E Lamar Alexander Parkway, Maryville, TN.

Cash / Self-Pay

$6,128

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,310

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: $6,128 (108%)

Insurance Median: $5,310 (94%)

Cash: $6,128 (108% of Medicare)

Ins. Median: $5,310 (94% 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.

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
UnitedHealthcare	$1,192 - $6,808	21%
Cigna	$1,200 - $6,842	21%
Medicaid / KanCare	$1,385 - $5,513	24%
Mvp Health Care [3037]	$3,765	66%
Golden Rule Insurance Company [2991]	$5,193	91%
Oxford Health Plans [2992]	$5,193	91%
Blue Cross Blue Shield	$5,206 - $5,746	92%
Humana	$5,206	92%
Medicare (plans)	$5,206 - $6,842	92%
Ambetter / Centene	$10,296	181%
Bob Jones Univ-Pai [821]	$10,382	183%
Consociate Health Contracted [4835]	$11,956	211%
Preferred Administrators Contracted [2839]	$13,844	244%
Fairos/Occunet Contracted [4837]	$14,613	257%
Promise Health Plan Contracted [2401]	$15,202	268%

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 $6,128.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 392.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Blount Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 392.
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.