CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Tristar Summit Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $7,015
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Tristar Summit Medical Center is $7,015. 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 1.24x the Medicare baseline. Located in 5655 Frist Blvd, Hermitage, TN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$7,015

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: $7,015 (124%)
Ins. Median: $7,015 (124% 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 - $7,153 11%
Apex Health $995 - $7,084 18%
Atrio Golden Times $1,275 - $7,153 22%
Prime Health $1,855 33%
Novanet $1,893 33%
United $2,625 - $10,400 46%
Corvel Corporation $2,840 50%
Blue Cross Blue Shield $3,344 - $10,602 59%
Wellpoint $4,814 85%
Ambetter / Centene $5,513 - $5,734 97%
Bright Health $6,071 - $8,185 107%
Alive Hospice, Inc. $6,534 115%
Amerigroup $6,878 121%
Humana $6,878 - $9,798 121%
Odyssey Healthcare $6,878 121%
Sarah Cannon Research $6,878 121%
Aetna $6,946 - $33,486 122%
Devoted Health Plan $7,015 124%
Healthspring $7,015 124%
Signature Advantage $7,015 124%
Evergreen Hmo $7,084 125%
Wellcare $7,084 125%
Zing $7,084 - $7,565 125%
Pruitt Health (Allyalign) $7,153 126%
American Health Advantage $7,222 127%
Oscar $8,964 158%
Multiplan $10,672 188%
Cigna $15,650 - $17,784 276%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5655 Frist Blvd, Hermitage, TN 37076
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals