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Hospital Profile Acute Care Hospital Government - Local 204 Beds · rural Updated: 2026-07-08

Cookeville Regional Medical Center

1 Medical Center Boulevard, Cookeville, TN 38501 · 8 Priced Procedures · 70% Patient Recommendation

CMS Overall Rating 2 / 5 Stars
Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Good Deal · Below Fair Market
0.66×vs. Fair Market Price
Position vs. 1.00× Fair Price34% Below Fair Price 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

Typical commercial prices here are 34% below the fair benchmark (0.66×) after accounting for local nurse/doctor wages and patient complexity.

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).71/100 · Corroborated
71/100Self-Pay Cash Beats Insurance 97% of the Time
File Completeness85Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic51Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment80Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing47Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount100Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.Premium Quality Tier
CMS Star Rating3/5 StarsOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety Score66/100Composite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER Wait249 minMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

3-Star CMS clinical quality rating paired with 0.66× fair market pricing.

Behavioral Pricing FingerprintLow Shoppable & Low Captive Rates

Uniform Value Leader · Low-Cost Across Departments

Cookeville Regional Medical Center maintains low, disciplined commercial pricing across both routine shoppable procedures (1.7× Medicare, p50 0.64× Fair BaseRate) and emergency/ancillary services (1.3× Medicare, p75 0.80× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.

#3 of 84 in TN · 2nd State Percentile#109 of 3,385 in U.S. · 3rd National Percentile
Advantage

Where They're Good (Patient & Payer Edge)

  • Elective shoppable care is priced 34% below peer Fair BaseRate (0.66×)
  • Self-pay cash beats commercial insurance on 97% of shoppable procedures (99/100 Cash Honesty)
  • 2-Star CMS clinical rating with 70% patient recommendation (66/100 safety score)
  • Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling
Watchout

Where You Can Get Burned (Markup Traps)

  • Outpatient surgery & OR suites carry a 2.1× markup over Medicare rates
  • Commercial insurance median sits at 0.64× Fair BaseRate (1.7× Medicare), so insured patients should always compare the self-pay cash price before paying.
  • Upper-quartile procedures (Q75 0.80×) jump +25% above the median procedure ratio (Q50 0.64×)
  • Consolidated metro market (HHI 7,419) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Front-Door ShoppableElective / Imaging
1.7× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER0.76× Divergence
1.3× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+25% Upper Tail
Q25 0.47× · Q50 0.64× · Q75 0.80×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.
Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×
Front-Door Shoppable CareFront-Door Shoppable
1.7× MedicareGood
Outpatient Surgery & ORBack-Door Captive
2.1× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
1.8× MedicareGood
Back-Door Captive ER VisitsBack-Door Captive
2.5× MedicareFair
Inpatient Lab & PathologyBack-Door Captive
2.2× MedicareFair
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
1.1× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
97% Cash Edge · 99/100Good
CMS Clinical Safety & Star ValueIntegrity & Outcomes
2 CMS · 66/100Fair

Procedure Prices at Cookeville Regional Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 8 published procedures.

Sort:
Audit a Bill & 501(r) Cap ↓
Procedure & Billing Code This Hospital vs. Fair
Hepatitis B immune globulin
HCPCS Code: 90371
 $466 unverified
Typhoid vaccine
HCPCS Code: 90675
 $526 1.5×
Varicella (chickenpox) vaccine
HCPCS Code: 90716
 $290 unverified
Pneumococcal vaccine
HCPCS Code: 90732
 $112 0.8×
Tdap vaccine (tetanus, diphtheria, pertussis)
HCPCS Code: 90715
 $82 unverified
Flu vaccine (high dose)
HCPCS Code: 90656
 $12 0.5×
Hepatitis B vaccine
HCPCS Code: 90744
 $17 0.5×
MMR vaccine (measles, mumps, rubella)
HCPCS Code: 90707
 $20 unverified
Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at Cookeville Regional Medical Center (Zero PHI Required)

CMS CCN: 440059
CPT 90371
Fair BaseRate™ $151
Medicare Rate $140
Self-Pay Cash $466
Insurer Median $466
Pre-filled with Cookeville Regional Medical Center’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
2026 FPL: $15,650 + $5,500 per additional person
Step 1 · 501(r) Charity Care Check 274% of 2026 FPL

Above Standard 400% FPL Financial-Assistance Ceiling

At 274% FPL, you exceed the standard 400% FPL tier, though medical-hardship caps (when bills exceed 10% of annual income) may still apply.

Step 2 · Cash vs. Insurance Arbitrage Save $412 Paying Cash

Self-Pay Cash Rate ($466) Beats Your Bill

Cookeville Regional Medical Center's published 45 CFR § 180 self-pay cash rate is $466 (vs. $466 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$727 Above Fair BaseRate

Negotiate Toward $151 Fair BaseRate ($140 Medicare)

Your bill ($878) is $727 above the denoised Fair BaseRate ($151) and 6.3× the $140 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.
IRS Form 990 Schedule H & 26 U.S.C. § 501(r) For-Profit / Non-501(c)(3)

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

EIN: 626002166

Public IRS & CMS ownership records classify Cookeville Regional Medical Center as a non-501(c)(3) facility. Federal 26 U.S.C. § 501(r) statutory charity-care caps apply specifically to tax-exempt nonprofit hospitals, though state hospital fair-pricing statutes and prompt-pay self-pay discounts may still apply.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑
CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall3/5 Stars (3/5)
Safety Composite66/100
Would Recommend70%
Rated 9 or 10 (HCAHPS)72%
Median ER Wait249 min
Left ER Before Seen1%
30-Day Mortality vs U.S.same
Unplanned Readmissionsame
Hip/Knee Complication Rate3.3%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)
Central-Line Bloodstream Infectionbetter
C. diff Hospital-Onset Infectionbetter

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Cookeville Regional Medical Center. Prior administrative notices do not necessarily reflect current compliance status.

  • 2026-04-15·warning_notice

    Warning Notice

    Recorded
  • 2026-02-09·administrative_or_closure

    Met Requirements

    Recorded
  • 2022-10-04·administrative_or_closure

    Closure Notice

    Recorded
  • 2022-07-27·cap_corrective_action

    CAP Request

    Recorded
  • 2021-10-27·warning_notice

    Warning Notice

    Recorded

Source: CMS Hospital Care Compare (668 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Higher-Quality, Above-Median Price Tier Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Cookeville Regional Medical Center.

Price Index: 1.32× regional baseline
Quality: 66/100 CMS composite
Median Household Income$56,537U.S. Census ACS
Local Uninsured Share9.5%Regional ACS estimate
200% FPL (1 Person)$31,920Common free-care ceiling
400% FPL (Family of 4)$128,600Common AGB cap ceiling
45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 71/100 · Corroborated CMS CCN 440059 EIN 626002166

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 440059) ↗ Verify IRS Form 990 (EIN 626002166) ↗ CMS HCRIS Cost Reports ↗
Published MRF File626002166_cookeville-regional-medical-center_standardcharges.csv
Publication / Vintage2026-07-08 · 4.43 MB
Validated Rate Rows155 (CMS v3.0.0)
File Integrity Digest888770571de7d058e5e5…

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy