CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Adventist Health Tehachapi Valley

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $13,180
Cash Discount Price: $7,053
vs. Medicare Baseline: 2.32x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Adventist Health Tehachapi Valley is $13,180. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,053. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 2.32x the Medicare baseline. Located in 1100 Magellan, Tehachapi, CA.

Cash / Self-Pay

$7,053

Average discount available for prompt cash payment at this facility.

Insurance Median

$13,180

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: $7,053 (124%)

Insurance Median: $13,180 (232%)

Cash: $7,053 (124% of Medicare)

Ins. Median: $13,180 (232% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 232% of the Medicare baseline (a markup of 132%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Cigna	$2,475	44%
Klhp-Kern Legacy Epo -All Other Plans	$4,632	82%
Blue Cross Blue Shield	$6,411 - $7,260	113%
Healthnet Medi-Cal	$6,429	113%
Oscar Health Plan- All Plans	$7,343	129%
Blue Shield Epn- All Other Plans	$9,981	176%
Kaiser Medi-Cal Ip/Op Only	$10,357	182%
Medi-Cal	$10,357	182%
Bc Mcal	$10,668	188%
UnitedHealthcare	$11,799 - $17,661	208%
Blue Shield Non-Epn	$12,516	221%
Ah Employee Health Plan - All Plans	$13,844	244%
Khs-Kern Hlth Systm Mcal	$14,189	250%
Healthnet Mcare	$17,661	311%
Medicare (plans)	$17,661	311%
Tricare	$17,661	311%
Healthnet- All Other Plans	$18,318	323%
Coventry- All Plans	$18,807	331%
Western Grwrs/Pinnacle - All Plans	$21,906	386%
Aetna	$21,943	387%
Network Providers- All Plans	$22,606	398%
Centivo - All Plans	$39,737	700%
Kaiser Ip/Op Only- All Other Plans	$56,498	995%

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 $7,053.
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 Tehachapi Valley 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.