Digestive disorders treatment (inpatient stay)
Facility: Adventist Health Lodi Memorial
Billing Code: 392 (MS-DRG)
- CPT Billing Code: 392
- Insurance Median: $13,594
- Cash Discount Price: $5,414
- vs. Medicare Baseline: 2.40x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 240% of the Medicare baseline (a markup of 140%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Hp Of San Joaquin Ppo - All Other Plans | $2,360 | 42% |
| Cigna | $3,956 | 70% |
| Healthnet Mcal | $6,429 | 113% |
| Alignment Health Plan (Ahp)-All Plans | $7,744 | 136% |
| Blue Shield Mcare Adv | $7,744 | 136% |
| Healthnet Mcare | $7,744 | 136% |
| Hp Of San Joaquin Mcr Adv | $7,744 | 136% |
| Humana | $7,744 | 136% |
| Kaiser Mcr Adv | $7,744 | 136% |
| Tricare | $7,744 | 136% |
| UnitedHealthcare | $7,744 - $31,714 | 136% |
| Cca Health Plan Mcr Adv- All Plans | $7,898 | 139% |
| Knnex Health - All Plans | $9,292 | 164% |
| Kaiser Mcal | $11,239 | 198% |
| Medi-Cal | $11,239 | 198% |
| Hp Of San Joaquin Mcal | $12,476 | 220% |
| Bc Mcal | $13,250 | 233% |
| Ah Employee Health Plan - All Plans | $13,938 | 246% |
| Bright Health - All Plans | $14,072 | 248% |
| Celtic Ins Company - All Plans | $17,232 | 304% |
| Blue Shield Epn - All Other Plans | $22,122 | 390% |
| Blue Shield Non-Epn | $22,895 | 403% |
| Western Growers- All Plans | $25,246 | 445% |
| Blue Cross Blue Shield | $30,332 - $34,052 | 534% |
| Networks By Design- All Plans | $30,579 | 539% |
| Kaiser Commercial - All Other Plans | $31,713 | 559% |
| Healthnet- All Other Plans | $43,759 | 771% |
| Aetna | $47,791 | 842% |
| First Health- All Plans | $58,011 | 1022% |
| Multiplan- All Plans | $61,879 | 1090% |
| Beech Street- All Plans | $69,614 | 1226% |
| Three Rivers Provider Network- All Plans | $69,614 | 1226% |