CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Tristar Northcrest Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $13,889
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.08x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Tristar Northcrest Medical Center is $13,889. 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 1.08x 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
$13,889

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: $13,889 (108%)
Ins. Median: $13,889 (108% 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.

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
United $1,911 - $30,531 15%
Prime Health $2,253 18%
Novanet $2,300 18%
Wellpoint $9,531 74%
Alive Hospice $12,255 96%
Molina $12,936 101%
Wellcare $12,936 - $13,616 101%
Bright Health $13,480 - $18,998 105%
Amerigroup $13,616 106%
Humana $13,616 - $22,157 106%
Aetna $13,753 - $43,768 107%
Devoted Health Plan $13,889 108%
Healthspring $13,889 108%
Ambetter / Centene $13,935 - $14,492 109%
Evergreen Hmo $14,025 110%
Zing $14,025 - $14,978 110%
Atrio Golden Times $14,161 111%
Blue Cross Blue Shield $14,161 - $16,930 111%
Nhc Advantage, Inc. $14,161 111%
American Health Advantage $14,297 112%
Cigna $18,507 - $21,031 145%
Oscar $20,271 158%

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