CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Paradise Valley Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $8,523
  • Cash Discount Price: $8,522
  • vs. Medicare Baseline: 1.50x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Paradise Valley Hospital is $8,523. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,522. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.50x the Medicare baseline. Located in 2400 East 4Th St, National City, CA.
Cash / Self-Pay
$8,522

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,523

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: $8,522 (150%)
Insurance Median: $8,523 (150%)
Cash: $8,522 (150% of Medicare)
Ins. Median: $8,523 (150% 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
Tricare $7,745 - $8,523 136%
Blue Shield Of Ca, Va $8,523 150%
Ca Foundation For Medical Care $8,523 150%
Central Health $8,523 150%
Choice Physicians Network $8,523 150%
Clever Care Of Golden State, Inc $8,523 150%
Community Health Group $8,523 150%
Health Excel Ins $8,523 150%
Health Net Of Ca $8,523 - $15,443 150%
Heritage Provider Netwrok $8,523 - $11,080 150%
Managed Health Network $8,523 150%
Medicare (plans) $8,523 150%
Molina $8,523 150%
Renal Payer Solutions $8,523 150%
UnitedHealthcare $8,523 150%
Usa Senior Care Network $8,523 150%
Verda Health Plan $8,523 150%
Brand New Day $8,608 152%
Imperial Health Plan Of Ca $9,034 159%
Health Net Federal Service (Cdcr) $10,654 188%
Employer Direct Healthcare $11,080 195%
Integrated Medical Solutions $11,080 195%
Ca Dept Of Correction & Rehab $11,932 210%
Naphcare $13,210 - $17,046 233%
National Healthcare Solutions, Inc (Nhsi) $13,636 240%
Aetna $13,911 245%
Worker Comp $14,341 253%
Scripps Health $14,489 255%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2400 East 4Th St, National City, CA 91950
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals