CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Baldwin Health

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $5,790
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.02x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Baldwin Health is $5,790. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.02x the Medicare baseline. Located in 1613 North McKenzie Street, Foley, AL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,790

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%)
Insurance Median: $5,790 (102%)
Ins. Median: $5,790 (102% 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medicaid / KanCare $643 - $1,083 11%
Viva Health $875 15%
Community Hospice $1,054 19%
Hospice $1,054 19%
Mercy Medical Hospice $1,054 19%
First Health $1,150 - $1,444 20%
One Health $1,250 22%
Alamed $1,292 23%
Multiplan Inc $1,368 24%
Coventry Work Comp Al $1,398 25%
Novanet $1,444 25%
Alabama Wc $1,520 27%
UnitedHealthcare $2,837 - $7,052 50%
Blue Cross Blue Shield $3,246 - $5,972 57%
First Choice $5,608 99%
Humana $6,152 108%
Medicare (plans) $6,193 - $6,829 109%
Windsor Health Plan $6,193 109%
Select Health $6,255 110%
Cigna $6,317 - $8,314 111%
Node Wellcare Mcr Adv $6,366 112%
Aetna $6,378 112%
Triwest $6,795 120%
Node Va $6,933 122%
Node Devoted Health Mcr Adv $6,965 123%
Node Clover Health Mcr Adv $7,003 123%
Ambetter / Centene $7,870 139%
Us Dol $10,921 192%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1613 North McKenzie Street, Foley, AL 36535
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals