CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Tristar Northcrest Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $6,872
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.21x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Tristar Northcrest Medical Center is $6,872. 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 1.21x the Medicare baseline. Located in 100 Northcrest Drive, Springfield, TN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,872

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: $6,872 (121%)
Ins. Median: $6,872 (121% 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
Nhc Advantage, Inc. $650 - $7,076 11%
United $845 - $10,400 15%
Atrio Golden Times $1,275 - $7,076 22%
Prime Health $1,855 33%
Novanet $1,893 33%
Blue Cross Blue Shield $4,225 - $7,076 74%
Wellpoint $4,763 84%
Ambetter / Centene $5,513 - $5,734 97%
Bright Health $6,071 - $8,185 107%
Alive Hospice $6,124 108%
Molina $6,464 114%
Wellcare $6,464 - $6,804 114%
Amerigroup $6,804 120%
Humana $6,804 - $9,798 120%
Aetna $6,872 - $33,486 121%
Devoted Health Plan $6,940 122%
Healthspring $6,940 122%
Evergreen Hmo $7,008 123%
Zing $7,008 - $7,484 123%
American Health Advantage $7,144 126%
Oscar $8,964 158%
Cigna $15,650 - $17,784 276%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Northcrest Drive, Springfield, TN 37172
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals