CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Adventist Health Mendocino Coast

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $23,986
Cash Discount Price: $21,555
vs. Medicare Baseline: 4.23x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Adventist Health Mendocino Coast is $23,986. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21,555. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 4.23x the Medicare baseline. Located in 700 River Drive, Fort Bragg, CA.

Cash / Self-Pay

$21,555

Average discount available for prompt cash payment at this facility.

Insurance Median

$23,986

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: $21,555 (380%)

Insurance Median: $23,986 (423%)

Cash: $21,555 (380% of Medicare)

Ins. Median: $23,986 (423% 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 423% of the Medicare baseline (a markup of 323%). 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
Tricare	$5,610	99%
Ah Employee Health Plan - All Plans	$10,124	178%
Blue Shield Epn	$15,648	276%
Multiplan - All Plans	$19,756	348%
Partnership Hp Mcal-All Plans	$20,040	353%
Great West Hmo/Pos/Epo/Oa	$21,228	374%
Healthnet - All Plans	$21,261	375%
Medi-Cal	$22,172	391%
Great West Ppo - All Other Plans	$22,861	403%
UnitedHealthcare	$25,112 - $31,662	442%
Cigna	$25,474	449%
Blue Shield - All Other Plans	$27,592	486%
Ahcc - All Plans	$29,393	518%
Beech Street - All Plans	$29,393	518%
Blue Cross Blue Shield	$29,438 - $65,808	519%

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 $21,555.
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 Mendocino Coast 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.