CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Tristar Southern Hills Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $17,887
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.40x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Tristar Southern Hills Medical Center is $17,887. 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 1.40x 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

$17,887

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: $17,887 (140%)

Ins. Median: $17,887 (140% 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	$2,987 - $31,369	23%
Corvel Corporation	$3,450	27%
Blue Cross Blue Shield	$7,878 - $42,485	62%
Wellpoint	$12,275	96%
Ambetter / Centene	$13,935 - $14,492	109%
Bright Health	$15,324 - $18,998	120%
Alive Hospice, Inc.	$16,659	130%
Amerigroup	$17,536	137%
Humana	$17,536 - $22,157	137%
Odyssey Healthcare	$17,536	137%
Sarah Cannon Research	$17,536	137%
Aetna	$17,712 - $43,768	138%
Devoted Health Plan	$17,887	140%
Healthspring	$17,887	140%
Wellcare	$18,062	141%
Zing	$18,062 - $19,290	141%
Nhc Advantage, Inc.	$18,238	142%
American Health Advantage	$18,413	144%
Evergreen Hmo	$18,413	144%
Signature Advantage	$18,413	144%
Cigna	$18,507 - $21,031	145%
Apex Health	$18,588	145%
Atrio Golden Times	$18,764	147%
Pruitt Health (Allyalign)	$18,764	147%
Oscar	$20,271	158%
Multiplan	$27,575	215%

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 Southern Hills 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.