CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Saint Agnes Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $8,225
  • Cash Discount Price: $23,072
  • vs. Medicare Baseline: 1.45x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Saint Agnes Medical Center is $8,225. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23,072. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.45x the Medicare baseline. Located in 1303 E Herndon Ave, Fresno, CA.
Cash / Self-Pay
$23,072

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,225

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: $23,072 (406%)
Insurance Median: $8,225 (145%)
Cash: $23,072 (406% of Medicare)
Ins. Median: $8,225 (145% 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
Health Smart $2,105 37%
Interplan $2,105 37%
Cba Network By Design $4,550 80%
Network Health $4,550 80%
Healthnet $5,005 - $5,570 88%
Aetna $5,920 - $7,942 104%
Coventry $6,191 109%
Multiplan $6,565 116%
Phcs $6,565 116%
Meritain $6,597 116%
Trustmark Small Business Benefits $6,597 116%
Advantek Central Usd $6,621 117%
Blue Cross Blue Shield $6,853 - $18,064 121%
Allied Benefit Systems $6,965 123%
Boon Chapman $6,965 123%
Hap $6,965 123%
Webtpa $6,965 123%
Medicare (plans) $6,966 - $8,347 123%
Humana $7,942 - $8,104 140%
UnitedHealthcare $8,100 - $14,444 143%
Welbe Health $9,263 163%
Align Senior Care $9,319 164%
Allegiance $10,717 189%
American Postal Workers Secondary $10,717 189%
Cigna $10,717 189%
Kaiser Permanente $14,181 250%
Geha $14,444 254%
Blue Shield - Ca $14,580 - $18,064 257%
Blue Benefit Administrators Of Massachusetts $18,064 318%
Blue Care Network $18,064 318%
Blue Distinction Transplant $18,064 318%
Blue Shield - Id (Regence) $18,064 318%
Blue Shield - Ny Highmark Northeastern $18,064 318%
Blue Shield - Ny Highmark Western $18,064 318%
Blue Shield - Pa (Highmark) $18,064 318%
Blue Shield - Wa (Regence) $18,064 318%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1303 E Herndon Ave, Fresno, CA 93720
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals