CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Memorialcare Saddleback Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $10,371
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.83x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Memorialcare Saddleback Medical Center is $10,371. 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 1.83x the Medicare baseline. Located in 24451 Health Center Drive, Laguna Hills, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$10,371

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: $10,371 (183%)
Ins. Median: $10,371 (183% 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
Scan Health Plan $6,765 119%
Monarch Health Plan $6,910 - $15,567 122%
Blue Shield $7,129 - $15,369 126%
Aetna $7,274 - $40,037 128%
Alignment Health Plan $7,274 128%
Blue Cross Blue Shield $7,274 - $19,145 128%
Citizens Choice $7,274 128%
Healthnet $7,274 - $27,360 128%
Heritage Provider Network $7,274 128%
Humana $7,274 128%
La Care $7,274 128%
Onecare $7,274 128%
Seoul Medical Group $7,274 128%
UnitedHealthcare $7,274 - $26,653 128%
Clever Care $7,638 135%
Easy Choice $7,638 135%
Select Health $7,638 - $9,820 135%
Universal Care $7,638 135%
Central Health $8,002 141%
Cigna $13,218 - $20,777 233%
Centivo $16,367 288%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 24451 Health Center Drive, Laguna Hills, CA 92653
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals