CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Tristar Summit Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $13,978
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Tristar Summit Medical Center is $13,978. 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 1.09x 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

$13,978

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: $13,978 (109%)

Ins. Median: $13,978 (109% 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	$2,811 - $29,445	22%
Corvel Corporation	$3,450	27%
Blue Cross Blue Shield	$7,563 - $42,485	59%
Wellpoint	$9,593	75%
Alive Hospice, Inc.	$13,019	102%
Bright Health	$13,567 - $18,998	106%
Amerigroup	$13,704	107%
Humana	$13,704 - $22,157	107%
Odyssey Healthcare	$13,704	107%
Sarah Cannon Research	$13,704	107%
Aetna	$13,841 - $43,768	108%
Ambetter / Centene	$13,935 - $14,492	109%
Devoted Health Plan	$13,978	109%
Healthspring	$13,978	109%
Signature Advantage	$13,978	109%
Apex Health	$14,115	110%
Evergreen HMO	$14,115	110%
Wellcare	$14,115	110%
Zing	$14,115 - $15,075	110%
Atrio Golden Times	$14,252	111%
Nhc Advantage, Inc.	$14,252	111%
Pruitt Health (Allyalign)	$14,252	111%
American Health Advantage	$14,389	112%
Cigna	$18,507 - $21,031	145%
Oscar	$20,271	158%
Multiplan	$24,134	188%

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 Summit 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.