CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Montclair Hospital Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $8,138
  • Cash Discount Price: $8,138
  • vs. Medicare Baseline: 1.43x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Montclair Hospital Medical Center is $8,138. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,138. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.43x the Medicare baseline. Located in 5000 San Bernardino Road, Montclair, CA.
Cash / Self-Pay
$8,138

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,138

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: $8,138 (143%)
Insurance Median: $8,138 (143%)
Cash: $8,138 (143% of Medicare)
Ins. Median: $8,138 (143% 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
Tricare $7,902 - $8,138 139%
Alignment $8,090 143%
Central Health Plan $8,090 143%
Choice Physicians Network $8,090 143%
Elite Health Plan $8,090 143%
Emanate Health $8,090 - $16,276 143%
Epic Health Plan $8,090 - $11,393 143%
Health Net Of Ca $8,090 - $14,746 143%
Inland Empire Healthplan $8,090 - $10,173 143%
Medicare (plans) $8,090 - $8,138 143%
Molina $8,090 - $8,138 143%
Renal Payor Solution $8,090 143%
Vantage Care $8,090 143%
Inland Empire Foundation For Medical Care $8,138 143%
Brand New Day $8,171 144%
Neighborhood $8,252 145%
Imperial Health Plan Of Ca $8,575 151%
Health Net Federal Services Prison (Cdcr) $10,173 179%
Employer Direct Health Care $10,580 186%
Coventry Workers Compensation $11,494 203%
National Healthcare Solutions, Inc (Nhsi) $13,021 229%
Worker Compensation $14,002 247%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5000 San Bernardino Road, Montclair, CA 91763
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals