CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Sonoma Valley Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $7,785
  • Cash Discount Price: $27,915
  • vs. Medicare Baseline: 1.37x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Sonoma Valley Hospital is $7,785. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27,915. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.37x the Medicare baseline. Located in 347 Andrieux St, Sonoma, CA.
Cash / Self-Pay
$27,915

Average discount available for prompt cash payment at this facility.

Insurance Median
$7,785

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: $27,915 (492%)
Insurance Median: $7,785 (137%)
Cash: $27,915 (492% of Medicare)
Ins. Median: $7,785 (137% 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
Hospice Of Marin-All Plans $1,517 27%
Ppo Alliance-All Plans $1,620 29%
By The Bay Health Ip Only - All Plans $1,700 30%
Bps-All Plans $1,780 31%
Comm Care Network(Ccn)-All Plans $2,000 35%
Great West-One Health Plan Ppo/Pos-All Plans $2,050 36%
Pref Health Networl(Phn)-All Plans $2,154 38%
Interplan-All Plans $2,780 49%
Pacificare (Mipa)-All Plans $4,300 76%
St Joseph Heritage Hltcare Comm-All Other Plans $4,943 87%
Healthnet Hmo/Ppo-All Other Plans $5,074 89%
Mcal Mgd Care (Php)-All Plans $5,766 102%
Partnership Healthplan-All Plans $5,766 102%
Champus-All Plans $6,576 116%
Tricare $7,504 132%
Blue Cross Blue Shield $7,736 - $22,485 136%
Bright Hlth/Brand New Day Mcr Adv $7,736 136%
Healthnet Senior $7,736 136%
Marin General Comm/Mcr Adv (Western Hlth)-All Plans $7,736 136%
St Joseph Heritage Hltcare Mcr Adv $7,736 136%
UnitedHealthcare $7,736 - $18,670 136%
Veterans Admin-All Plans $7,736 136%
Scan Mcare-All Plans $7,785 137%
Medi-Cal $8,243 145%
Blue Shield Ppo-All Plans $8,938 157%
Cdcr Prison-All Plans $9,283 164%
Correct Care Integ Health-All Plans $9,283 164%
Employer Direct Healthcare-All Plans $9,283 164%
Three Rivers (Trpn)-All Plans $9,283 164%
Phcs/Multiplan/Beech St-All Plans $10,000 176%
Chp - Correctional Health Partners - All Plans $10,057 177%
Creative Legal Services-All Plans $10,057 177%
Wellpath - All Plans $10,830 191%
Bright Hlth/Brand New Day - All Other Plands $11,217 198%
Canopy Health Solutions-All Other Plans $11,875 209%
Cigna $13,060 230%
Aetna $13,213 233%
First Health(Coventry)-All Plans $13,213 233%
Vnpn - All Plans $13,925 245%
M-Cal (Eds) Ip Only - All Plans $16,509 291%
Kaiser-All Plans $25,921 457%
Integrated Health Plan-All Plans $29,510 520%
Networks By Design - All Plans $31,902 562%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 347 Andrieux St, Sonoma, CA 95476
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals