CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: West Anaheim Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $8,194
Cash Discount Price: $8,193
vs. Medicare Baseline: 1.44x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at West Anaheim Medical Center is $8,194. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,193. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.44x the Medicare baseline. Located in 3033 W Orange Avenue, Anaheim, CA.

Cash / Self-Pay

$8,193

Average discount available for prompt cash payment at this facility.

Insurance Median

$8,194

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: $8,193 (144%)

Insurance Median: $8,194 (144%)

Cash: $8,193 (144% of Medicare)

Ins. Median: $8,194 (144% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$7,842	138%
Central Health Plan	$7,842	138%
Health Net Of Ca	$7,842 - $14,847	138%
Health Net Of Ca Mhn (Bh)	$7,842	138%
Managed Health Network	$7,842	138%
Molina	$7,842 - $8,194	138%
Renal Payor Solutions	$7,842	138%
Verda Health Plan	$7,842	138%
Brand New Day	$7,920	140%
Tricare	$8,161	144%
Blue Shield Of Ca Triwest	$8,194	144%
Medicare (plans)	$8,194	144%
Imperial Health Plan Of Ca Inc	$8,312	146%
Health Net Federal Services	$10,242	180%
Employer Direct Healthcare Surgery Plus	$10,652	188%
Naphcare (Santa Ana - County Jail)	$12,700	224%
Naphcare Residential Treatment Center	$12,700	224%
National Healthcare Solutions, Inc (Nhsi)	$13,110	231%
Ca Foundation For Medical Care	$13,637	240%
Workers Compensation	$13,637	240%
Aetna	$14,193	250%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $8,193.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 392.

Insurance In-Network Protection Plan

Contact your insurance company to confirm West Anaheim Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 392.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.