CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Lafollette Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $7,233
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.27x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Lafollette Medical Center is $7,233. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.27x the Medicare baseline. Located in 923 East Central Avenue, La Follette, TN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$7,233

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%)
Insurance Median: $7,233 (127%)
Ins. Median: $7,233 (127% 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.

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Commercial Insurance Negotiated Rates

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

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Node Hospice Non Par Agree $1,047 18%
Bluecare $1,141 - $2,301 20%
Medicaid / KanCare $1,306 - $3,167 23%
UnitedHealthcare $1,306 - $7,611 23%
Blue Cross Blue Shield $1,315 - $7,250 23%
Beech Street Work Comp Tn $1,913 34%
Novanet Work Comp Tn $1,913 34%
Tn Work Comp $1,932 34%
Amerigroup $2,751 48%
Aetna $3,167 - $18,274 56%
Wellcare $3,167 56%
Humana $3,321 - $7,250 59%
Node Bluecare Plus Tn Mcr Adv $5,088 90%
Triwest $7,216 127%
Medicare (plans) $7,250 128%
Node Wellcare Mcr Adv $7,363 130%
Node Devoted Health Mcr Adv $7,395 130%
Node Farm Bureau Mcr Adv $7,395 130%
Node Blueadvantage Mcr Adv $7,467 132%
Node Healthspring Mcr Adv $7,467 132%
Node Va $7,510 132%
Node Amerigroup Mcr Adv $7,611 134%
Windsor Health Plan $7,611 134%
Node Nhc Mcr Adv $7,972 140%
Self Pay $8,435 149%
Node Us Dept Of Labor $11,493 202%
Ambetter / Centene $13,621 240%
Node Point Comfort Underwriters $16,198 285%
Multiplan Complementary $22,329 393%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 923 East Central Avenue, La Follette, TN 37766
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals