CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Providence St Mary Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $8,505
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.50x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Providence St Mary Medical Center is $8,505. 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 1.50x the Medicare baseline. Located in 18300 Highway 18, Apple Valley, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,505

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: $8,505 (150%)
Ins. Median: $8,505 (150% 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
Aetna $8,505 150%
Blue Cross Blue Shield $8,505 150%
Blue Shield $8,505 - $17,292 150%
Brand New Day $8,505 150%
Caremore $8,505 150%
Central Health Plan $8,505 150%
Cigna $8,505 150%
Healthcare Partners $8,505 150%
Healthnet $8,505 - $14,659 150%
Heritage Provider Network $8,505 150%
Humana $8,505 150%
Inland Empire Health Plan $8,505 150%
Kaiser $8,505 150%
La Care $8,505 150%
Molina $8,505 150%
Monarch Health Plan $8,505 150%
Onecare $8,505 150%
Providence Health Plan $8,505 150%
Scan $8,505 150%
UnitedHealthcare $8,505 - $12,894 150%
Wellcare $8,505 150%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 18300 Highway 18, Apple Valley, CA 92307
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals