CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Tristar Southern Hills Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $10,178
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.79x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Tristar Southern Hills Medical Center is $10,178. 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 1.79x the Medicare baseline. Located in 391 Wallace Rd, Nashville, TN.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$10,178

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: $10,178 (179%)

Ins. Median: $10,178 (179% 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.

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
Nhc Advantage, Inc.	$650 - $10,586	11%
Apex Health	$995 - $10,789	18%
Atrio Golden Times	$1,275 - $10,891	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	$3,484 - $10,602	61%
Ambetter / Centene	$5,513 - $5,734	97%
Bright Health	$6,071 - $10,077	107%
Wellpoint	$7,125	126%
Oscar	$8,964	158%
Alive Hospice, Inc.	$9,670	170%
Humana	$9,798 - $10,178	173%
Amerigroup	$10,178	179%
Odyssey Healthcare	$10,178	179%
Sarah Cannon Research	$10,178	179%
Aetna	$10,280 - $33,486	181%
Devoted Health Plan	$10,382	183%
Healthspring	$10,382	183%
Wellcare	$10,484	185%
Zing	$10,484 - $11,196	185%
American Health Advantage	$10,687	188%
Evergreen Hmo	$10,687	188%
Signature Advantage	$10,687	188%
Pruitt Health (Allyalign)	$10,891	192%
Multiplan	$12,194	215%
Cigna	$15,650 - $17,784	276%

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: 392.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Tristar Southern Hills Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 392.
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.