CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Physicians Regional Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $6,164
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.09x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Physicians Regional Medical Center is $6,164. 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 1.09x the Medicare baseline. Located in 7565 Dannaher Way Powell, Powell, TN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,164

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: $6,164 (109%)
Ins. Median: $6,164 (109% 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
Node Hospice Non Par Agree $1,047 18%
Blue Cross Blue Shield $1,344 - $6,309 24%
Medicaid / KanCare $1,459 26%
UnitedHealthcare $1,459 - $6,431 26%
Novanet Work Comp Tn $1,913 34%
Occunet Work Comp Tn $1,932 34%
Tn Work Comp $1,932 34%
Amerigroup $2,743 - $6,431 48%
Amerigroup Community Care $2,743 48%
Node Bluecare Plus Tn Mcr Adv $4,985 - $5,052 88%
Humana $6,114 - $6,127 108%
Medicare (plans) $6,127 - $6,418 108%
Node Farm Bureau Mcr Adv $6,235 110%
Aetna $6,309 - $7,455 111%
Node Healthspring Mcr Adv $6,309 111%
Self Pay $6,393 - $6,655 113%
Wellcare $6,451 114%
Node Va $6,513 - $6,643 115%
Node Devoted Health Mcr Adv $6,545 115%
Node Nhc Mcr Adv $6,736 119%
Node Us Dept Of Labor $10,360 183%
Us Department Of Labor $10,360 183%
Node Point Comfort Underwriters $11,500 - $12,049 203%
Ambetter / Centene $12,049 212%
Multiplan $15,865 - $20,860 280%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7565 Dannaher Way Powell, Powell, TN 37849
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals