CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Tristar Stonecrest Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $16,167
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.15x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Tristar Stonecrest Medical Center is $16,167. 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 $14,116.91, this hospital’s rate is 1.15x the Medicare baseline. Located in 200 Stonecrest Boulevard, Smyrna, TN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$16,167

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$14,116.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $14,116.91 (100%)
Insurance Median: $16,167 (115%)
Ins. Median: $16,167 (115% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $14,116.91 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
Prime Health $1,855 13%
Novanet $1,893 13%
United $2,625 - $16,007 19%
Corvel Corporation $2,840 20%
Blue Cross Blue Shield $6,144 - $29,106 44%
Wellpoint $11,205 79%
Ambetter / Centene $13,737 - $14,287 97%
Alive Hospice, Inc. $15,207 108%
Bright Health $15,322 - $20,657 109%
Amerigroup $16,007 113%
Humana $16,007 - $24,413 113%
Odyssey Healthcare $16,007 113%
Sarah Cannon Research $16,007 113%
Aetna $16,167 - $33,486 115%
Devoted Health Plan $16,327 116%
Healthspring $16,327 116%
Signature Advantage $16,327 116%
Apex Health $16,487 117%
Evergreen Hmo $16,487 117%
Wellcare $16,487 117%
Zing $16,487 - $17,608 117%
Atrio Golden Times $16,647 118%
Nhc Advantage, Inc. $16,647 118%
Pruitt Health (Allyalign) $16,647 118%
American Health Advantage $16,807 119%
Oscar $22,335 158%
Cigna $34,595 - $39,312 245%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Stonecrest Boulevard, Smyrna, TN 37167
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals