CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: AHMC Seton Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $9,380
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.65x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at AHMC Seton Medical Center is $9,380. 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 1.65x the Medicare baseline. Located in 1900 Sullivan Avenue, Daly City, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$9,380

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: $9,380 (165%)
Ins. Median: $9,380 (165% 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Healthcare Foundation Of San Mateo $1,657 - $1,907 29%
San Mateo County/San Mateo County General Hospital $1,802 32%
Chinese Community Health Plan $2,578 - $9,380 45%
The First Health Network $2,700 48%
UnitedHealthcare $3,544 - $9,536 62%
Blue Cross Blue Shield $4,165 - $9,395 73%
Cigna $4,204 - $4,673 74%
Blue Shield Of California $4,494 - $14,106 79%
Ahmc Health $4,591 81%
Health Net $5,003 88%
Aetna $5,413 - $9,380 95%
Veterans Administration (Va) $6,675 118%
Care Advantage $9,380 165%
For Your Benefit $9,380 165%
Healthnet Seniority $9,380 165%
Humana $9,380 165%
Imperial Health Plan $9,380 165%
Jade Health Care Mg $9,380 165%
Medicare (plans) $9,380 165%
North East Medical Services $9,380 165%
Pacificare $9,380 165%
Canopy Health $9,536 - $21,456 168%
Covid-19 Uninsured Program $9,536 168%
Kaiser $9,536 168%
Easy Choice Hospital Services $9,632 170%
Brand New Day $10,131 - $11,920 178%
Central Health Plan $10,131 178%
Knox-Keene Act $11,920 210%
Athens Administrators $13,163 232%
Corvel Healthcare $13,163 232%
Multiplan/Bce Emergis $13,163 232%
Work Comp Other $13,163 232%
Workers Compensation Federal $13,931 245%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1900 Sullivan Avenue, Daly City, CA 94015
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals