CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Grandview Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $4,527
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.80x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Grandview Medical Center is $4,527. 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 0.80x the Medicare baseline. Located in 3690 Grandview Parkway, Birmingham, AL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,527

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: $4,527 (80%)
Ins. Median: $4,527 (80% 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.

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
Mhca Psych $775 14%
American Behavioral $900 16%
Medicaid / KanCare $1,052 19%
Hospice $1,093 19%
Bp Health Advocate $1,100 19%
Healthchoice $1,400 - $1,500 25%
Natl Comp Care $2,802 49%
Coventry Work Comp Al $3,033 53%
First Health $3,033 53%
Novanet $3,132 55%
UnitedHealthcare $3,135 - $5,906 55%
Alabama Wc $3,297 58%
Blue Cross Blue Shield $3,352 59%
Viva Health $3,763 - $5,472 66%
Healthspring $4,015 71%
Alamed $4,392 77%
Blue Advantage $5,191 91%
Humana $5,462 96%
Victory Health $5,462 96%
Medicare (plans) $5,472 - $5,690 96%
Select Health $5,527 97%
Cigna $5,581 - $8,098 98%
Aetna $5,636 99%
Node Wellcare Mcr Adv $5,649 100%
Node Devoted Health Mcr Adv $5,803 102%
Node Clover Health Mcr Adv $5,828 103%
Node Va $5,886 104%
Choicecare $6,627 117%
Ambetter / Centene $7,506 132%
Node Us Dept Of Labor $9,370 165%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3690 Grandview Parkway, Birmingham, AL 35243
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals