CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Adventist Health Delano

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $8,461
Cash Discount Price: $2,289
vs. Medicare Baseline: 1.49x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Adventist Health Delano is $8,461. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,289. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.49x the Medicare baseline. Located in 1401 Garces Highway, Delano, CA.

Cash / Self-Pay

$2,289

Average discount available for prompt cash payment at this facility.

Insurance Median

$8,461

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: $2,289 (40%)

Insurance Median: $8,461 (149%)

Cash: $2,289 (40% of Medicare)

Ins. Median: $8,461 (149% 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
Kern Health System Mcal	$3,064	54%
Gem Care- All Plans	$4,400	78%
County Of Kern Network - All Plans	$4,776	84%
Blue Shield Non-Epn	$5,396	95%
Coventry- All Plans	$6,868	121%
Healthnet- All Other Plans	$7,568	133%
Aetna	$8,140	143%
Kaiser Medi-Cal Ip/Op Only	$8,422	148%
Medi-Cal	$8,422	148%
Universal Care Mcal	$8,422	148%
Bakersfield Fam Med Grp-All Plans	$8,461	149%
Healthnet Mcr Adv	$8,461	149%
Kern Mcr Adv Dual Dnsp-All Other Plans	$8,461	149%
Medicare (plans)	$8,461 - $11,447	149%
Tricare	$8,461	149%
UnitedHealthcare	$8,461 - $9,538	149%
Universal Care Mcr- All Other Plans	$8,461	149%
Foundation For Medical Care Of Kern County - All Plans	$8,586	151%
Cigna	$9,158	161%
Western Growers - All Plans	$9,185	162%
Blue Cross Blue Shield	$9,525 - $9,937	168%
Blue Shield Epn - All Other Plans	$11,234	198%
Kaiser Comm Ip/Op Only- All Other Plans	$11,447	202%
Ah Employee Health Plan - All Plans	$15,230	268%
Centivo - All Plans	$19,037	335%

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 $2,289.
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 Adventist Health Delano 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.