CMS Price Transparency Data
Digestive disorders treatment (inpatient stay)
Facility: Mercy Hospital Fort Smith
Billing Code: 392 (MS-DRG)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 392
- Insurance Median: $6,400
- Cash Discount Price: $13,647
- vs. Medicare Baseline: 1.13x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Mercy Hospital Fort Smith is $6,400. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13,647. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.13x the Medicare baseline. Located in 7301 Rogers Ave, Fort Smith, AR.
Cash / Self-Pay
$13,647
Average discount available for prompt cash payment at this facility.
Insurance Median
$6,400
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: $13,647 (240%)
Insurance Median: $6,400 (113%)
Cash: $13,647 (240% of Medicare)
Ins. Median: $6,400 (113% 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 |
|---|---|---|
| Workers Comp [20426] | $1,271 | 22% |
| Aetna | $2,993 - $8,264 | 53% |
| Humana | $2,993 - $7,444 | 53% |
| Medicaid / KanCare | $2,993 - $5,672 | 53% |
| Private Health Care Systems Contracted [320320] | $4,659 | 82% |
| Private Health Care Systems [20320] | $4,659 | 82% |
| Novasys Contracted [320285] | $5,270 - $5,672 | 93% |
| Ambetter / Centene | $5,672 | 100% |
| Home State Health Plan Contracted [320187] | $5,672 | 100% |
| Tricare | $5,998 | 106% |
| Blue Cross Blue Shield | $6,268 - $8,498 | 110% |
| American Health Advantage Of Mo Mcr [20264] | $6,400 | 113% |
| Cross Timbers Hospice [20098] | $6,400 | 113% |
| Elara Caring Aspire Hospice Contracted [320433] | $6,400 | 113% |
| Elara Caring Aspire Hospice [20433] | $6,400 | 113% |
| Globalhealth Contracted [320145] | $6,400 | 113% |
| Halo Hcr Inc Hospice Contracted [320432] | $6,400 | 113% |
| Halo Hcr Inc Hospice [20432] | $6,400 | 113% |
| Independent Health [20197] | $6,400 | 113% |
| Jordan Valley Senior Care Pace [20515] | $6,400 | 113% |
| Kindful Hospice Contracted [320434] | $6,400 | 113% |
| Kindful Hospice [20434] | $6,400 | 113% |
| Medical Associates Health [20444] | $6,400 | 113% |
| Medicare (plans) | $6,400 - $7,000 | 113% |
| Mercy Hospice Okc [20252] | $6,400 | 113% |
| Pace Of The Ozarks [20518] | $6,400 | 113% |
| Provider Partners Health Plans Contracted [320450] | $6,400 | 113% |
| Qual Choice Contracted [320325] | $6,400 | 113% |
| Spina Bifida Hlthcare Benefit [20506] | $6,400 | 113% |
| Tribute Health Plan Mcr [20338] | $6,400 | 113% |
| UnitedHealthcare | $6,400 - $9,749 | 113% |
| Valir Pace [20503] | $6,400 | 113% |
| Wellfirst Health Mcr [20443] | $6,400 | 113% |
| Cherokee Nation Health Serv Contracted [320066] | $6,726 | 119% |
| Dept Of Veteran Affairs Contracted [320106] | $6,726 | 119% |
| Indian Health Service Contracted [320198] | $6,726 | 119% |
| Indian Health Service [20198] | $6,726 | 119% |
| Cigna | $6,856 - $8,894 | 121% |
| Municipal Health Plan Contracted [320271] | $7,640 | 135% |
| Employers Health Coalition Contracted [320116] | $7,744 | 136% |
| Aither Health Contracted [320449] | $8,029 | 141% |
| Edison Health Solutions Contracted [320502] | $8,029 | 141% |
| Mercy Benefit Admin Contracted [320251] | $8,029 | 141% |
| Usable Contracted [320409] | $8,498 | 150% |
| United Medical Resources Contracted [320454] | $9,749 | 172% |
| Health Choice Contracted [320166] | $9,803 | 173% |
| Qual Choice Contracted [320324] | $9,980 | 176% |
| First Health Contracted [320128] | $10,012 | 176% |