CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Providence Santa Rosa Memorial Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $9,227
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.63x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Providence Santa Rosa Memorial Hospital is $9,227. 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 1.63x the Medicare baseline. Located in 1165 Montgomery Dr, Santa Rosa, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$9,227

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: $9,227 (163%)
Ins. Median: $9,227 (163% 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
Healthnet $9,042 - $21,423 159%
Aetna $9,227 - $25,677 163%
Blue Cross Blue Shield $9,227 163%
Blue Shield $9,227 - $24,426 163%
Brand New Day $9,227 163%
Caremore $9,227 163%
Central Health Plan $9,227 163%
Cigna $9,227 163%
Humana $9,227 163%
Kaiser $9,227 163%
Providence Health Plan $9,227 163%
Scan Health Plan $9,227 163%
UnitedHealthcare $9,227 - $18,739 163%
Western Health Advantage $9,227 163%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1165 Montgomery Dr, Santa Rosa, CA 95405
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals