CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Encino Hospital Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $8,079
  • Cash Discount Price: $7,621
  • vs. Medicare Baseline: 1.42x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Encino Hospital Medical Center is $8,079. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,621. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.42x the Medicare baseline. Located in 16237 Ventura Blvd, Encino, CA.
Cash / Self-Pay
$7,621

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,079

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: $7,621 (134%)
Insurance Median: $8,079 (142%)
Cash: $7,621 (134% of Medicare)
Ins. Median: $8,079 (142% 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
Alignment $7,622 134%
Blue Shield Of Ca, Va $7,622 134%
Blue Shield Of Promise $7,622 134%
Health Net Of Ca $7,622 - $13,811 134%
La Care Health Plan $7,622 134%
Managed Health Network $7,622 134%
Medicare (plans) $7,622 134%
Molina $7,622 134%
Renal Payer Solutions $7,622 134%
Tricare $7,622 - $7,697 134%
Usa Senior Care Network $7,622 134%
Brand New Day $7,698 - $9,262 136%
Aids Healthcare Foundation $7,774 137%
Imperial Health Plan Ca $8,079 142%
Corvel $8,689 153%
Zelis Healthcare $8,689 153%
Americas Choice Provider Network $8,872 156%
Multiplan $8,872 156%
Prime Health Services, Inc. $8,872 156%
Three Rivers $8,872 156%
Healthsmart Preferred Care Network $8,963 158%
Provider Select $9,055 160%
Provider Network Of America $9,146 161%
Employer Direct Healthcare $9,908 175%
Aetna $11,133 196%
Workers Comp $11,477 202%
National Healthcare Solutions, Inc (Nhsi) $12,195 215%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 16237 Ventura Blvd, Encino, CA 91436
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals