CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Tristar Horizon Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $14,332
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.12x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Tristar Horizon Medical Center is $14,332. 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 $12,807.1, this hospital’s rate is 1.12x the Medicare baseline. Located in 111 Highway 70 East, Dickson, TN.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$14,332

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$12,807.1

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $12,807.1 (100%)

Insurance Median: $14,332 (112%)

Ins. Median: $14,332 (112% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $12,807.1 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
Prime Health	$2,253	18%
Novanet	$2,300	18%
United	$3,271 - $34,824	26%
Corvel Corporation	$3,450	27%
Blue Cross Blue Shield	$5,577 - $39,026	44%
Wellpoint	$9,695	76%
Alive Hospice, Inc.	$13,348	104%
Bright Health	$13,910 - $18,998	109%
Ambetter / Centene	$13,935 - $14,492	109%
Amerigroup	$14,051	110%
Humana	$14,051 - $22,157	110%
Sarah Cannon Research	$14,051	110%
Aetna	$14,191 - $43,768	111%
Devoted Health Plan	$14,332	112%
Healthspring	$14,332	112%
Signature Advantage	$14,332	112%
Apex Health	$14,472	113%
Evergreen Hmo	$14,472	113%
Wellcare	$14,472	113%
Zing	$14,472 - $15,456	113%
Atrio Golden Times	$14,613	114%
Nhc Advantage, Inc.	$14,613	114%
Pruitt Health (Allyalign)	$14,613	114%
American Health Advantage	$14,754	115%
Cigna	$18,507 - $21,031	145%
Oscar	$20,271	158%

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 $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 322.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Tristar Horizon Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 322.
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.