CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Garden Grove Hospital & Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $7,748
  • Cash Discount Price: $7,747
  • vs. Medicare Baseline: 1.37x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Garden Grove Hospital & Medical Center is $7,748. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,747. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.37x the Medicare baseline. Located in 12601 Garden Grove Blvd, Garden Grove, CA.
Cash / Self-Pay
$7,747

Average discount available for prompt cash payment at this facility.

Insurance Median
$7,748

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: $7,747 (136%)
Insurance Median: $7,748 (137%)
Cash: $7,747 (136% of Medicare)
Ins. Median: $7,748 (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
Tricare $7,639 135%
Blue Shield Of Ca $7,748 137%
Central Health Plan $7,748 137%
Health Net Of Ca $7,748 - $14,039 137%
Innovative Mgmt Svcs $7,748 137%
Medcare Partners Health Plan $7,748 137%
Medicare (plans) $7,748 137%
Molina $7,748 137%
Patient Choice Health Plan $7,748 137%
Renal Payer Solutions $7,748 137%
Verda Healthplan $7,748 137%
Brand New Day $7,825 138%
Imperial Health Plan Of Ca $8,213 145%
Employer Direct Healthcare $10,072 177%
Aetna $11,268 199%
Naphcare $12,009 212%
National Healthcare Solutions, Inc (Nhsi) $12,396 218%
Workers Compensation $14,456 255%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12601 Garden Grove Blvd, Garden Grove, CA 92843
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals