Digestive disorders treatment (inpatient stay)
Facility: Sonoma Specialty Hospital, LLC
Billing Code: 392 (MS-DRG)
- CPT Billing Code: 392
- Insurance Median: $37,437
- Cash Discount Price: $38,343
- vs. Medicare Baseline: 6.60x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 660% of the Medicare baseline (a markup of 560%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $13,420 - $58,340 | 236% |
| Medi-Cal Ip Only | $13,420 | 236% |
| Alameda Alliance Ip Only-All Other Plans | $16,650 | 293% |
| Kaiser Ip Only-All Plans | $18,729 | 330% |
| Contra Costa Ip Only-All Plans | $23,400 | 412% |
| Align Sr Care Ca Inc Ip Only-All Plans | $25,200 | 444% |
| Sfhp Ip Only-All Plans | $25,200 | 444% |
| Networks By Design Ip Only-All Plans | $25,962 | 457% |
| Healthnet Mcal Ip Only | $28,075 | 495% |
| Cca Mcal Ip Only-All Plans | $29,875 | 526% |
| Aetna | $45,000 | 793% |
| Multiplan Ip Only - All Plans | $54,319 | 957% |
| Alameda Alliance Mcr Ip Only | $58,340 | 1028% |
| Blue Shield Mcr Ip Only | $58,340 | 1028% |
| Cchs/Cdcr/Cci/Hnet Fed Ip Only-All Plans | $58,340 | 1028% |
| Healthnet Mcr Ip Only | $58,340 | 1028% |
| Triwest Ip Only- All Plans | $58,340 | 1028% |
| Healthnet Prison Ip Only | $63,905 | 1126% |
| Healthnet Cdcr Mcr Ip Only | $84,397 | 1487% |
| Healthnet Ip Only - All Other Plans | $105,012 | 1850% |