CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Providence St. Joseph Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $8,422
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.48x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Providence St. Joseph Hospital is $8,422. 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 1.48x the Medicare baseline. Located in 1100 West Stewart Dr, Orange, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,422

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: $8,422 (148%)
Ins. Median: $8,422 (148% 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
Aetna $8,422 148%
Beacon Health $8,422 148%
Blue Cross Blue Shield $8,422 - $10,650 148%
Blue Shield $8,422 - $16,818 148%
Brand New Day $8,422 148%
Caremore $8,422 148%
Central Health Plan $8,422 148%
Cigna $8,422 148%
Healthcare Partners $8,422 148%
Healthnet $8,422 - $20,183 148%
Heritage Provider Network $8,422 148%
Humana $8,422 148%
Inland Empire Health Plan $8,422 148%
Kaiser $8,422 148%
La Care $8,422 148%
Managed Health Network $8,422 148%
Molina $8,422 148%
Monarch Health Plan $8,422 - $12,329 148%
Onecare $8,422 148%
Providence Health Plan $8,422 148%
UnitedHealthcare $8,422 - $20,740 148%
Providence $9,490 167%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 West Stewart Dr, Orange, CA 92868
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals