Ambetter ER Visit Rates in Nashville
Published Ambetter negotiated rates for ER Visit at 15 hospitals in Nashville, TN. Data from CMS-mandated hospital transparency files.
If you are experiencing a medical emergency, call 911 or go to your nearest emergency room immediately.
Do not delay emergency care based on cost.
Lowest Rate
$105.34
Vanderbilt University Medical Center
all plan types
Highest Rate
$1,800
TriStar Summit Medical Center
all plan types
Rate Spread
17x
across all plan types
Hospitals
15
with Ambetter data
Ambetter's negotiated ER visit rates in Nashville span a 17x range, from $105.34 at Vanderbilt University Medical Center (Exchange) to $1,800 at TriStar Centennial Medical Center. Across 15 hospitals, the median rate is $565.40. Keep in mind that the lowest rates listed are often tied to Medicaid or Medicare plan types rather than commercial coverage.
Ambetter ER Visit Rates by Hospital
| Hospital | Lowest Ambetter Rate |
|---|---|
| Vanderbilt University Medical Center | $105.34 |
| Ascension Saint Thomas Midtown | $344.73 |
| Ascension Saint Thomas Rutherford | $344.73 |
| Ascension Saint Thomas West | $344.73 |
| Metro Nashville General Hospital | $366.64 |
| Vanderbilt Wilson County Hospital | $444.66 |
| Maury Regional Medical Center | $686.72 |
| TriStar Centennial Medical Center | $805 |
| TriStar Hendersonville Medical Center | $805 |
| TriStar Horizon Medical Center | $805 |
| TriStar NorthCrest Medical Center | $805 |
| TriStar Skyline Medical Center | $805 |
| TriStar Southern Hills Medical Center | $805 |
| TriStar StoneCrest Medical Center | $805 |
| TriStar Summit Medical Center | $805 |
Median of all 87 published Ambetter rates for ER Visit at these hospitals: $565.40
Rates shown are Ambetter's published negotiated rates from each hospital's CMS transparency file. "Lowest rate" is the lowest rate across all Ambetter plan types (including Medicaid-managed and Medicare Advantage) at that hospital. Commercial plan rates are typically higher. Your actual cost depends on your specific plan's deductible, copay, and coinsurance.
Reading Ambetter ER Visit Rates in Nashville
Where Ambetter ER visit rates in Nashville begin and end. Among the 15 hospitals with Ambetter rates, the low end starts at Vanderbilt University Medical Center with $105.34, followed by Ascension Saint Thomas Midtown, Ascension Saint Thomas Rutherford and Ascension Saint Thomas West, each with $344.73. At the top, TriStar Centennial Medical Center, TriStar Hendersonville Medical Center and TriStar Horizon Medical Center each show $1,800 as their highest published rate.
The spread across Nashville hospitals and the plan behind each rate. The published rates run 17x from lowest to highest, and the median of all 87 published Ambetter rates for this procedure at these hospitals is $565.40. The plan types beside the lowest rates are labeled Exchange or are internal plan names, not Medicaid, CHIP or Medicare Advantage, so the plan behind a rate is not always clearly stated. A single hospital can also list several plans, so a rate may not match the plan you hold.
What an Ambetter member can ask in Nashville. These are facility rates, and professional fees are billed separately.
- Ask Ambetter for your own plan's negotiated rate and estimated cost share at a named hospital, such as Vanderbilt University Medical Center.
- Ask Ambetter whether that hospital is in network for your plan.
- Ask the hospital for an estimate of the ER visit.
Written from the rates in the table above. General information, not medical or insurance advice.
Understanding Ambetter Negotiated Rates
A negotiated rate is the price Ambetter has agreed to pay a hospital for a specific service. This is not necessarily what you pay out of pocket. If you have met your annual deductible, you typically pay a copay or coinsurance percentage of the negotiated rate. If you have not met your deductible, you may owe the full negotiated rate.
The same insurer often negotiates different rates at different hospitals, and different plan types (HMO, PPO, high-deductible) within the same insurer can have different rates at the same hospital. The table above shows the range across all Ambetter plan types at each facility.
Prices shown are facility fees only. You will also receive separate bills from the physician performing the procedure.
Compare Other Insurers for ER Visit in Nashville
Frequently Asked Questions
Where is the lowest-cost Ambetter ER Visit in Nashville?
The lowest Ambetter negotiated rate for ER Visit in Nashville is $105.34 at Vanderbilt University Medical Center, across all plan types including Medicaid-managed and Medicare Advantage. The highest is $1,800 at TriStar Summit Medical Center, a 17x difference. Commercial plan rates typically fall between these extremes.
Is the Ambetter negotiated rate what I'll pay?
Not necessarily. The negotiated rate is what Ambetter has agreed to pay the hospital. Your out-of-pocket cost depends on your deductible, copay, and coinsurance. If you have not met your annual deductible, you may owe the full negotiated rate. Contact Ambetter for a pre-service cost estimate specific to your plan.
How many Nashville hospitals have published Ambetter rates?
15 hospitals in the Nashville area have published Ambetter negotiated rates for ER Visit in their CMS transparency files. Having a published rate does not necessarily confirm current network participation. Verify your network status with Ambetter directly.
Will Ambetter cover an out-of-network ER visit?
Under the No Surprises Act, emergency services must be covered regardless of network status. Ambetter cannot charge you more than your in-network cost-sharing for emergency care, even at an out-of-network hospital. This applies to the ER visit itself, though follow-up care after you are stabilized may be billed differently.
We are not affiliated with Ambetter or any hospital listed on this page. Negotiated rates are sourced from hospital-published CMS transparency files and represent the amounts agreed between the insurer and hospital. Your actual out-of-pocket cost depends on your deductible, copay, and coinsurance. Contact Ambetter or the hospital billing department for a cost estimate specific to your plan. All insurer and hospital names are trademarks of their respective owners.
Visit the official Ambetter website: www.ambetterhealth.com