CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Carilion Tazewell Community Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $14,003
Cash Discount Price: $7,811
vs. Medicare Baseline: 2.47x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Carilion Tazewell Community Hospital is $14,003. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,811. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 2.47x the Medicare baseline. Located in 388 Ben Bolt Avenue, Tazewell, VA.

Cash / Self-Pay

$7,811

Average discount available for prompt cash payment at this facility.

Insurance Median

$14,003

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: $7,811 (138%)

Insurance Median: $14,003 (247%)

Cash: $7,811 (138% of Medicare)

Ins. Median: $14,003 (247% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 247% of the Medicare baseline (a markup of 147%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$4,904 - $7,565	86%
Aetna	$6,972 - $14,818	123%
Humana	$7,269 - $23,451	128%
Allcare	$7,417	131%
UnitedHealthcare	$7,639 - $18,241	135%
Sentara Health Plan	$7,788 - $13,836	137%
Vhn - Ultra	$13,836	244%
Cigna	$14,171 - $15,108	250%
Gateway - Tier 3	$15,175	267%
Connecticare	$15,621	275%
Vhn - Plus	$17,183	303%
Gateway - Tier 2	$17,853	315%
Vhn	$17,853	315%
Integrated Health Plan	$18,968	334%
Vhn - Link	$20,084	354%
Gateway - Tier 1	$21,200	374%
Vhn - Secondary Payors	$21,200	374%
National Provider Network	$21,423	377%

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 $7,811.
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 Carilion Tazewell Community Hospital 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.