CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Highpoint Health-Riverview With Ascension Saint Th

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $2,060
  • Cash Discount Price: $9,488
  • vs. Medicare Baseline: 0.36x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Highpoint Health-Riverview With Ascension Saint Th is $2,060. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,488. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 0.36x the Medicare baseline. Located in 158 Hospital Drive, Carthage, TN.
Cash / Self-Pay
$9,488

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,060

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%)
Cash / Self-Pay: $9,488 (167%)
Insurance Median: $2,060 (36%)
Cash: $9,488 (167% of Medicare)
Ins. Median: $2,060 (36% 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
Cigna $1,400 25%
Aetna $2,060 36%
Amerigroup $2,060 36%
Blue Cross Blue Shield $2,060 - $4,595 36%
Healthspring $2,060 36%
Humana $2,060 36%
Medicare (plans) $2,060 36%
UnitedHealthcare $2,060 - $2,990 36%
Veterans Admin - Governmental $2,060 36%
Wellcare $2,060 36%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 158 Hospital Drive, Carthage, TN 37030
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals