CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Greater El Monte Community Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $8,890
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.57x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Greater El Monte Community Hospital is $8,890. 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 1.57x the Medicare baseline. Located in 1701 Santa Anita Ave, South El Monte, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,890

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: $8,890 (157%)
Ins. Median: $8,890 (157% 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
Care 1St Medi Cal Hmo Cap Exceptional Care $725 13%
Universal Care $725 - $858 13%
Intercomp $750 13%
Community Care Network $800 14%
Lincoln Hospital Medical Center $830 15%
Interplan $875 - $14,469 15%
Caloptima $892 16%
Central Health Plan $900 16%
Employee Health Systems Medical Group $900 16%
California Thoroughbred Horesmans Foundation $950 17%
Cost Containment Strategies $975 17%
Care First Health Plan $1,100 19%
Blue Cross Blue Shield $1,350 - $8,890 24%
Molina Healthcare Of California $1,350 - $11,295 24%
Health Net Foundation $1,500 - $10,310 26%
La Care Health Plan $1,700 - $8,890 30%
Care 1St Health Plan $1,750 31%
Ahmc Reciprocity Agreement Senior/Commercial $1,850 33%
Ahmc Healthcare Inc $1,937 34%
Ahmc Reciprocity Agreement $2,562 45%
Health Net Inc $2,714 - $12,732 48%
One Legacy $3,000 53%
Pacificare Of California $3,222 - $9,036 57%
Ahmc Health Self-Insurance Epo $3,618 64%
Blue Shield Of California $4,149 - $11,639 73%
Veterans Administration $6,325 111%
Cigna $6,750 119%
Beverly Hospital $8,828 - $9,940 156%
Aids Health Foundation $8,890 157%
Altamed Health Network $8,890 157%
Apa/Aco Inc $8,890 157%
Avanti $8,890 - $10,843 157%
Brand New Day $8,890 - $11,295 157%
Cms $8,890 157%
Easy Choice Health Plan $8,890 157%
Other Non Contracted Senior Hmo $8,890 157%
Pacific Alliance Medical Center Reciprocal Contract $8,890 157%
Scan Health Plan $8,890 157%
UnitedHealthcare $8,890 157%
Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P $9,036 159%
Emanate Health $9,036 - $11,295 159%
La Care Covered Direct $9,036 159%
Self-Pay $9,036 159%
Alignment Health Plan $9,335 164%
Molina Healthcare $9,335 164%
Inter Valley Health Plan $9,488 167%
San Miguel Health Plan $9,940 175%
Chinatown Service Center Pace $10,668 188%
Knox-Keene Act $11,295 199%
Preferred Health Network $14,171 250%
Athens Administrators $14,917 263%
Multiplan $14,917 263%
Other Non Contracted Work Comp $14,917 263%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1701 Santa Anita Ave, South El Monte, CA 91733
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals