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Dr. Kyle S. Joyner, MD

(Dr. Kyle Steven Joyner, MD)

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Specializes in: Orthopedics/Orthopedic Surgery and Hand Surgery

Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine

Professional interests include: musculoskeletal problems, elbow problems, wrist problems, and more.

1800 Medical Center Parkway Suite 200
Murfreesboro, TN 37129

(615) 267-6600

Dr. Kyle S. Joyner, MD is an orthopedist in Murfreesboro, TN specializing in orthopedics/orthopedic surgery and hand surgery. He graduated from Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine. Dr. Kyle S. Joyner, MD is affiliated with TriStar Health, TriStar StoneCrest Medical Center, Tennessee Orthopaedic Alliance, Ascension and Ascension Saint Thomas Rutherford.

Office Locations

1800 Medical Center Parkway Suite 200
Murfreesboro, TN 37129

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2160 Rock Springs Road Suite 100
Smyrna, TN 37167

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300 Stonecrest Boulevard Suite 300 Tennessee Orthopaedic Alliance
Smyrna, TN 37167

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5109 Veterans Parkway
Murfreesboro, TN 37128

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Some issues Dr. Kyle S. Joyner, MD can help you with:

Musculoskeletal Problems

The musculoskeletal system refers collectively to the bones, joints, ligaments, muscles, and nerves. It is what gives the body structure and movement. Because this system encompasses so much of the body, musculoskeletal problems are extremely varied and can happen almost anywhere. There are musculoskeletal problems that affect only the joints, those that affect the bones, those that affect tendons and ligaments, and those that can happen in any area of the body but cause pain and numbness.

Joint problems include bursitis and arthritis. Bursitis is the inflammation of a fluid-filled sac cushion on the outside of a joint, causing symptoms including pain and swelling. Arthritis is the inflammation and damage of a joint due to wear and tear or disease. There are several treatments for arthritis, but if the damage progresses far enough, joint replacement may be necessary. In joint replacement, a metal or plastic implant is surgically placed within the joint to make movement easier.

Bone problems include scoliosis, fractures, and osteoporosis. Scoliosis is a curvature of the spine, making the normally straight spine look like a 'C' or 'S.' It is treated with braces or surgery. Osteoporosis is a disease that causes bones to weaken and break easily. It's most common in women, especially older women. Fully half of all women over 65 have osteoporosis. Fractures are any break in the bone. They can be a simple crack or a severe and complicated shatter. Osteoporosis causes fractures in people who have it, but other causes are trauma (such as a fall) or overuse.

Tendon and ligament problems most often result from injury or overuse. Two good examples are ligament tears and tendonitis. The most common ligament tear is the ACL tear in the knee. This ligament supports and stabilizes the knee and is most often torn during sports activities. Tendonitis happens when a tendon, which connects muscles and bones together, becomes irritated and inflamed. This happens most often in older patients who push their bodies too far, leading to pain and swelling. Treatment for both tendon and ligament problems usually includes rest, ice, and supporting the area to let it heal.

Pain and numbness problems can be caused by overuse, disease, an injury, or a compressed nerve. Lower back pain and carpal tunnel syndrome are two of the most common conditions patients encounter. Lower back pain may be caused by sore muscles that have been overworked, or an injury to the disks separating the vertebrae in the spine. Lower back pain usually goes away on its own within a few days, but it may require medical treatment depending on the cause. Carpal tunnel syndrome occurs when the nerve at the base of the palm becomes trapped or pinched. Symptoms include tingling, pain, numbness, or weakness in the hand. Treatment involves rest and sometimes steroid injections.

Because the musculoskeletal system involves so much of the body, problems here can be incredibly varied in their type and severity. Some musculoskeletal problems will go away on their own or only require rest, while others may require medication, physical therapy, or even surgery.

Noteworthy Medicare Patient Procedures Performed by Dr. Kyle S. Joyner, MD in 2023

Click on any procedure below to see further details on volume and pricing among Medicare patients.

Top 25%

By Volume:

total shoulder replacement

By Affordability:

MRI

In 2012, among providers in related specialties within Tennessee, Dr. Kyle S. Joyner, MD performed more total shoulder replacement procedures for Medicare patients than 75% of them and he also had a list price for MRI (magnetic resonance imaging) that was lower than the list prices billed to Medicare by 75% of them. Actual amounts paid by patients can vary widely depending on a number of factors, including insurance coverage. A lower list price, however, might mean lower fees when paying without insurance.

Medicare Procedure and Patient Information

2012 Medicare Procedure Volume

The top procedures that Dr. Kyle S. Joyner, MD treated as an orthopedist in Murfreesboro, TN during 2012 were injections, aspiration, musculoskeletal imaging and hospital care.

Volume of procedures performed by Dr. Kyle S. Joyner, MD for Medicare patients.

aspiration	66
decompression surgery	17
doctor visit	322
hospital care	29
injections	97
inpatient care	29
minimally invasive procedures	17
MRI (magnetic resonance imaging)	18
musculoskeletal imaging	37
nerve procedures	17
upper extremity surgery	17
X-rays	19

Medicare Procedure and Patient Information

2013 Medicare Procedure Volume

The top procedures that Dr. Kyle S. Joyner, MD treated as an orthopedist in Murfreesboro, TN during 2013 were injections, aspiration, upper extremity surgery and hospital care.

Volume of procedures performed by Dr. Kyle S. Joyner, MD for Medicare patients.

aspiration	47
decompression surgery	17
doctor visit	331
hospital care	21
injections	73
inpatient care	21
joint surgery	11
minimally invasive procedures	17
nerve procedures	17
reconstructive surgery	11
upper extremity surgery	28

2013 Medicare Patient Data

Information about Medicare patients treated by Dr. Kyle S. Joyner, MD.

**Gender**
Male	86
Female	172

**Ethnicity**
Non-Hispanic White	245
Black	0
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	127
From 75 to 84	68
85 and over	26
Less than 65	37

Conditions of Medicare patients treated by Dr. Kyle S. Joyner, MD in 2013

Hypertension	73
High Cholesterol	63
Stroke	0
Ischemic Heart Disease	35
Depression	29
Chronic Kidney Disease	20
Asthma	9
Osteoperosis	14
Atrial Fibrilation	11
Heart Failure	22
Chronic Obstructive Pulmonary Disease	13
Diabetes	33
Dementia	13
Cancer	7

Medicare Procedure and Patient Information

2014 Medicare Procedure Volume

The top procedures that Dr. Kyle S. Joyner, MD treated as an orthopedist in Murfreesboro, TN during 2014 were injections, aspiration, musculoskeletal imaging and X-rays.

Volume of procedures performed by Dr. Kyle S. Joyner, MD for Medicare patients.

aspiration	86
doctor visit	413
hip imaging	22
hospital care	28
injections	132
inpatient care	28
joint surgery	16
MRI (magnetic resonance imaging)	17
musculoskeletal imaging	58
reconstructive surgery	16
upper extremity surgery	16
X-rays	41

2014 Medicare Patient Data

Information about Medicare patients treated by Dr. Kyle S. Joyner, MD.

**Gender**
Male	101
Female	211

**Ethnicity**
Non-Hispanic White	294
Black	0
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	151
From 75 to 84	88
85 and over	28
Less than 65	45

Conditions of Medicare patients treated by Dr. Kyle S. Joyner, MD in 2014

Hypertension	72
High Cholesterol	59
Stroke	4
Ischemic Heart Disease	30
Depression	26
Chronic Kidney Disease	24
Asthma	8
Osteoperosis	16
Atrial Fibrilation	7
Heart Failure	16
Chronic Obstructive Pulmonary Disease	14
Diabetes	33
Dementia	11
Cancer	8

Medicare Procedure and Patient Information

2015 Medicare Procedure Volume

The top procedures that Dr. Kyle S. Joyner, MD treated as an orthopedist in Murfreesboro, TN during 2015 were injections, aspiration, musculoskeletal imaging and inpatient care.

Volume of procedures performed by Dr. Kyle S. Joyner, MD for Medicare patients.

aspiration	89
decompression surgery	12
doctor visit	418
hospital care	38
injections	124
inpatient care	38
joint surgery	20
minimally invasive procedures	12
MRI (magnetic resonance imaging)	18
musculoskeletal imaging	53
nerve procedures	12
reconstructive surgery	20
upper extremity surgery	32
X-rays	35

2015 Medicare Patient Data

Information about Medicare patients treated by Dr. Kyle S. Joyner, MD.

**Gender**
Male	240
Female	428

**Ethnicity**
Non-Hispanic White	636
Black	0
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	320
From 75 to 84	180
85 and over	76
Less than 65	92

Conditions of Medicare patients treated by Dr. Kyle S. Joyner, MD in 2015

Hypertension	70
High Cholesterol	61
Stroke	6
Ischemic Heart Disease	35
Depression	30
Chronic Kidney Disease	27
Asthma	12
Osteoperosis	15
Atrial Fibrilation	10
Heart Failure	19
Chronic Obstructive Pulmonary Disease	13
Diabetes	29
Dementia	13
Cancer	6

Medicare Procedure and Patient Information

2016 Medicare Procedure Volume

The top procedures that Dr. Kyle S. Joyner, MD treated as an orthopedist in Murfreesboro, TN during 2016 were injections, aspiration, upper extremity surgery and joint surgery.

Volume of procedures performed by Dr. Kyle S. Joyner, MD for Medicare patients.

aspiration	96
decompression surgery	29
doctor visit	475
excision	11
hospital care	37
injections	135
inpatient care	37
joint surgery	43
minimally invasive procedures	40
MRI (magnetic resonance imaging)	27
musculoskeletal imaging	27
nerve procedures	17
reconstructive surgery	20
upper extremity surgery	60

2016 Medicare Patient Data

Information about Medicare patients treated by Dr. Kyle S. Joyner, MD.

**Gender**
Male	132
Female	249

**Ethnicity**
Non-Hispanic White	357
Black	0
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	187
From 75 to 84	106
85 and over	30
Less than 65	58

Conditions of Medicare patients treated by Dr. Kyle S. Joyner, MD in 2016

Hypertension	72
High Cholesterol	60
Stroke	5
Ischemic Heart Disease	28
Depression	29
Chronic Kidney Disease	30
Asthma	17
Osteoperosis	9
Atrial Fibrilation	10
Heart Failure	15
Chronic Obstructive Pulmonary Disease	15
Diabetes	29
Dementia	8
Cancer	7

Medicare Procedure and Patient Information

2017 Medicare Procedure Volume

The top procedures that Dr. Kyle S. Joyner, MD treated as an orthopedist in Murfreesboro, TN during 2017 were injections, aspiration, upper extremity surgery and hospital care.

Volume of procedures performed by Dr. Kyle S. Joyner, MD for Medicare patients.

aspiration	79
decompression surgery	19
doctor visit	399
hospital care	34
injections	113
inpatient care	34
joint surgery	18
minimally invasive procedures	19
MRI (magnetic resonance imaging)	23
musculoskeletal imaging	23
nerve procedures	19
reconstructive surgery	18
upper extremity surgery	37

2017 Medicare Patient Data

Information about Medicare patients treated by Dr. Kyle S. Joyner, MD.

**Gender**
Male	144
Female	216

**Ethnicity**
Non-Hispanic White	331
Black	0
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	179
From 75 to 84	101
85 and over	42
Less than 65	38

Conditions of Medicare patients treated by Dr. Kyle S. Joyner, MD in 2017

Hypertension	71
High Cholesterol	58
Stroke	6
Ischemic Heart Disease	31
Depression	29
Chronic Kidney Disease	32
Asthma	5
Osteoperosis	10
Atrial Fibrilation	8
Heart Failure	16
Chronic Obstructive Pulmonary Disease	12
Diabetes	29
Dementia	10
Cancer	12

Medicare Procedure and Patient Information

2018 Medicare Procedure Volume

The top procedures that Dr. Kyle S. Joyner, MD treated as an orthopedist in Murfreesboro, TN during 2018 were injections, upper extremity surgery, aspiration and musculoskeletal imaging.

Volume of procedures performed by Dr. Kyle S. Joyner, MD for Medicare patients.

aspiration	60
decompression surgery	17
doctor visit	317
hospital care	20
injections	77
inpatient care	20
joint surgery	22
minimally invasive procedures	17
MRI (magnetic resonance imaging)	26
musculoskeletal imaging	26
nerve procedures	17
reconstructive surgery	22
tendon surgery	24
upper extremity surgery	63

2018 Medicare Patient Data

Information about Medicare patients treated by Dr. Kyle S. Joyner, MD.

**Gender**
Male	106
Female	179

**Ethnicity**
Non-Hispanic White	269
Black	0
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	156
From 75 to 84	74
85 and over	26
Less than 65	29

Conditions of Medicare patients treated by Dr. Kyle S. Joyner, MD in 2018

Hypertension	73
High Cholesterol	61
Stroke	0
Ischemic Heart Disease	31
Depression	26
Chronic Kidney Disease	27
Asthma	5
Osteoperosis	11
Atrial Fibrilation	9
Heart Failure	16
Chronic Obstructive Pulmonary Disease	12
Diabetes	32
Dementia	8
Cancer	11

Medicare Procedure and Patient Information

2019 Medicare Procedure Volume

The top procedures that Dr. Kyle S. Joyner, MD treated as an orthopedist in Murfreesboro, TN during 2019 were injections, aspiration, musculoskeletal imaging and upper extremity surgery.

Volume of procedures performed by Dr. Kyle S. Joyner, MD for Medicare patients.

aspiration	97
decompression surgery	19
doctor visit	348
injections	118
joint surgery	21
minimally invasive procedures	19
MRI (magnetic resonance imaging)	25
musculoskeletal imaging	42
nerve procedures	19
reconstructive surgery	21
upper extremity surgery	40
X-rays	17

2019 Medicare Patient Data

Information about Medicare patients treated by Dr. Kyle S. Joyner, MD.

**Gender**
Male	109
Female	168

**Ethnicity**
Non-Hispanic White	258
Black	0
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	157
From 75 to 84	75
85 and over	17
Less than 65	28

Conditions of Medicare patients treated by Dr. Kyle S. Joyner, MD in 2019

Hypertension	67
High Cholesterol	65
Stroke	0
Ischemic Heart Disease	32
Depression	28
Chronic Kidney Disease	33
Asthma	5
Osteoperosis	10
Atrial Fibrilation	10
Heart Failure	14
Chronic Obstructive Pulmonary Disease	13
Diabetes	32
Dementia	7
Cancer	10

Medicare Procedure and Patient Information

2020 Medicare Procedure Volume

The top procedures that Dr. Kyle S. Joyner, MD treated as an orthopedist in Murfreesboro, TN during 2020 were injections, aspiration, upper extremity surgery and minimally invasive procedures.

Volume of procedures performed by Dr. Kyle S. Joyner, MD for Medicare patients.

aspiration	119
debridement (removal of unhealthy tissue)	11
decompression surgery	31
doctor visit	388
injections	169
joint surgery	37
minimally invasive procedures	42
MRI (magnetic resonance imaging)	19
musculoskeletal imaging	33
nerve procedures	20
reconstructive surgery	15
upper extremity surgery	57
X-rays	14

2020 Medicare Patient Data

Information about Medicare patients treated by Dr. Kyle S. Joyner, MD.

**Gender**
Male	151
Female	171

**Ethnicity**
Non-Hispanic White	298
Black	13
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	180
From 75 to 84	91
85 and over	14
Less than 65	37

Conditions of Medicare patients treated by Dr. Kyle S. Joyner, MD in 2020

Hypertension	68
High Cholesterol	63
Stroke	0
Ischemic Heart Disease	29
Depression	23
Chronic Kidney Disease	32
Asthma	6
Osteoperosis	9
Atrial Fibrilation	5
Heart Failure	13
Chronic Obstructive Pulmonary Disease	10
Diabetes	32
Dementia	6
Cancer	8

Medicare Procedure and Patient Information

2021 Medicare Procedure Volume

The top procedures that Dr. Kyle S. Joyner, MD treated as an orthopedist in Murfreesboro, TN during 2021 were injections, aspiration, upper extremity surgery and nerve procedures.

Volume of procedures performed by Dr. Kyle S. Joyner, MD for Medicare patients.

aspiration	96
decompression surgery	20
doctor visit	352
injections	138
joint surgery	13
minimally invasive procedures	20
MRI (magnetic resonance imaging)	20
musculoskeletal imaging	20
nerve procedures	20
reconstructive surgery	13
upper extremity surgery	33

2021 Medicare Patient Data

Information about Medicare patients treated by Dr. Kyle S. Joyner, MD.

**Gender**
Male	137
Female	161

**Ethnicity**
Non-Hispanic White	279
Black	0
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	178
From 75 to 84	77
85 and over	22
Less than 65	21

Conditions of Medicare patients treated by Dr. Kyle S. Joyner, MD in 2021

Hypertension	68
High Cholesterol	59
Stroke	0
Ischemic Heart Disease	32
Depression	20
Chronic Kidney Disease	30
Asthma	6
Osteoperosis	7
Atrial Fibrilation	7
Heart Failure	11
Chronic Obstructive Pulmonary Disease	11
Diabetes	29
Dementia	5
Cancer	7

Medicare Procedure and Patient Information

2022 Medicare Procedure Volume

The top procedures that Dr. Kyle S. Joyner, MD treated as an orthopedist in Murfreesboro, TN during 2022 were injections, aspiration, upper extremity surgery and minimally invasive procedures.

Volume of procedures performed by Dr. Kyle S. Joyner, MD for Medicare patients.

aspiration	152
debridement (removal of unhealthy tissue)	12
decompression surgery	45
doctor visit	335
injections	177
joint surgery	45
minimally invasive procedures	57
MRI (magnetic resonance imaging)	27
musculoskeletal imaging	27
nerve procedures	31
reconstructive surgery	19
tendon surgery	19
upper extremity surgery	95

2022 Medicare Patient Data

Information about Medicare patients treated by Dr. Kyle S. Joyner, MD.

**Gender**
Male	143
Female	172

**Ethnicity**
Non-Hispanic White	292
Black	11
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	179
From 75 to 84	92
85 and over	20
Less than 65	24

Conditions of Medicare patients treated by Dr. Kyle S. Joyner, MD in 2022

Hypertension	75
High Cholesterol	74
Stroke	4
Ischemic Heart Disease	30
Depression	21
Chronic Kidney Disease	20
Asthma	10
Osteoperosis	12
Atrial Fibrilation	14
Heart Failure	6
Chronic Obstructive Pulmonary Disease	14
Diabetes	31
Dementia	0
Cancer	11

Medicare Procedure and Patient Information

2023 Medicare Procedure Volume

The top procedures that Dr. Kyle S. Joyner, MD treated as an orthopedist in Murfreesboro, TN during 2023 were injections, aspiration, upper extremity surgery and musculoskeletal imaging.

Volume of procedures performed by Dr. Kyle S. Joyner, MD for Medicare patients.

aspiration	155
decompression surgery	37
doctor visit	425
injections	198
joint surgery	22
minimally invasive procedures	37
MRI (magnetic resonance imaging)	40
musculoskeletal imaging	54
nerve procedures	37
reconstructive surgery	22
tendon surgery	27
upper extremity surgery	86
X-rays	14

2023 Medicare Patient Data

Information about Medicare patients treated by Dr. Kyle S. Joyner, MD.

**Gender**
Male	165
Female	207

**Ethnicity**
Non-Hispanic White	343
Black	13
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	211
From 75 to 84	125
85 and over	0
Less than 65	0

Conditions of Medicare patients treated by Dr. Kyle S. Joyner, MD in 2023

Hypertension	75
High Cholesterol	75
Stroke	6
Ischemic Heart Disease	31
Depression	20
Chronic Kidney Disease	20
Asthma	9
Osteoperosis	12
Atrial Fibrilation	13
Heart Failure	9
Chronic Obstructive Pulmonary Disease	14
Diabetes	28
Dementia	0
Cancer	10

Medicare Procedure and Patient Information

Average Medicare Procedure Volume From 2012 - 2023

Volume of procedures performed by Dr. Kyle S. Joyner, MD for Medicare patients.

The highest averages for the top procedures that Dr. Kyle S. Joyner, MD treated as an orthopedist in Murfreesboro, TN were injections, aspiration, upper extremity surgery and musculoskeletal imaging.

aspiration	95
debridement (removal of unhealthy tissue)	11
decompression surgery	23
doctor visit	376
excision	11
hip imaging	22
hospital care	29
injections	129
inpatient care	29
joint surgery	24
minimally invasive procedures	27
MRI (magnetic resonance imaging)	23
musculoskeletal imaging	36
nerve procedures	20
reconstructive surgery	17
tendon surgery	23
upper extremity surgery	47
X-rays	23

Average Medicare Patient Data From 2012 - 2023

Information about Medicare patients treated by Dr. Kyle S. Joyner, MD.

**Gender**
Male	126
Female	194

**Ethnicity**
Black / African American	3
Asian / Pacific Islander	0
Non-Hispanic White	300
Hispanic	0
Native American / Alaskan Native	0
Other	0

**Age**
75 to 84	89
85 and over	25
Less than 65	34
65 to 74	168

Average of Total of Conditions of Medicare patients treated by Dr. Kyle S. Joyner, MD From 2012 - 2023

The highest averages of the most common conditions of Medicare patients that Dr. Kyle S. Joyner, MD treated were hypertension, high cholesterol, diabetes and ischemic heart disease.

Hypertension	65
High Cholesterol	58
Stroke	2
Ischemic Heart Disease	28
Depression	23
Chronic Kidney Disease	24
Asthma	7
Osteoporosis	10
Heart Failure	13
Chronic Obstructive Pulmonary Disease	11
Diabetes	28
Atrial Fibrillation	8
Cancer	8
Dementia	6

Education & Training

Dr. Kyle S. Joyner, MD graduated from Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine. He completed residency at University of Texas Medical Branch At Galveston. He is certified by the American Board of Orthopaedic Surgery and has a state license in Tennessee.

Medical School: Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine

Residency: University of Texas Medical Branch At Galveston

Board Certification: American Board of Orthopaedic Surgery

Licensed In: Tennessee

Affiliations & Hospitals

Dr. Kyle S. Joyner, MD is associated with these hospitals and organizations:

TriStar Health

TriStar StoneCrest Medical Center

Tennessee Orthopaedic Alliance

Ascension

Ascension Saint Thomas Rutherford

Ratings & Reviews

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General Payments

These charts describe general payments received by Dr. Kyle S. Joyner, MD. Doctors may receive payments for a number of reasons, including meal compensation, travel compensation, and consulting.

**Payments by Company**
Alpha Orthopedic Systems	$4,326 ALL ARTHREX PRODUCT LINES $17	$4,308
Arthrex, Inc.	$274 ARTHROPLASTY IMPLANTS REVERS TOTAL SHOULDER MODULAR GLENOID SYSTEMS $68	$206
Gilead Sciences, Inc.	$121 $121
Zimmer Biomet Holdings, Inc.	$93 Comprehensive Reverse $93
DePuy Synthes Sales Inc.	$76 MILAGRO $76
Other	$385 XIAFLEX $96	SURGICAL PAIN REGIONAL ANESTHESIA $72	BLUEPRINT PSI SYSTEM $50	AEQUALIS ASCEND FLEX $36	AVANCE NERVE GRAFT $27	Other $104

**Types of Payments**
Education	$3,866
Food and Beverage	$957
Travel and Lodging	$451

Biography

Dr. Kyle Joyner is a specialist in hand surgery and orthopedics/orthopedic surgery. Areas of expertise for Dr. Joyner include hand problems, wrist problems, and shoulder problems. He studied medicine at Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine. Dr. Joyner is affiliated with Tennessee Orthopaedic Alliance, Ascension, and TriStar StoneCrest Medical Center.