CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: North Shore Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $8,318
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.47x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at North Shore Medical Center is $8,318. 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 1.47x the Medicare baseline. Located in 1100 Nw 95Th St, Miami, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,318

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: $8,318 (147%)
Ins. Median: $8,318 (147% 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Hospice Other $1,091 19%
Aetna $2,169 - $7,922 38%
Dimension Health Wc $2,283 40%
Workers Compensation $2,283 40%
Humana $4,098 - $7,763 72%
Veterans Administration Mill Bill $5,545 98%
Bc/Bs Myblue Hmo Hix $6,186 109%
Bc/Bs Of Fl Health Options Hmo $6,186 109%
Bc/Bs Of Fl Simplyblue $6,186 109%
Cigna $7,413 - $9,754 131%
Medicare (plans) $7,525 - $17,305 133%
Oscar Health Plan Hix $7,535 133%
Leon Health Inc $7,888 139%
Devoted Health $7,922 140%
UnitedHealthcare $7,922 - $16,656 140%
Veterans Administration Vaccn $8,049 142%
Florida Pace Centers $8,318 147%
Healthsun Health Plans $8,318 147%
Bc/Bs Of Fl Network Blue $8,404 148%
Molina Marketplace Program Exchange $8,420 148%
Longevity Health Plan $8,451 149%
Bc/Bs Of Fl Blue Select Exchange Non Par $9,244 163%
Avmed Broad Network $9,568 169%
Bright Health Management Commercial $9,659 170%
Centurion Prison $9,902 174%
Self Pay/Uninsured $9,902 174%
Employer Direct Healthcare $10,061 177%
Imagine Health $10,909 192%
Bc/Bs Of Fl Phs $11,597 204%
Bc/Bs Of Fl Ppo $11,597 204%
Avmed Exchange $14,086 248%
Ambetter / Centene $14,891 262%
Auto Insurance $16,098 284%
Avmed Select Network $16,477 290%
Amerihealth Caritas Next Exchange $17,305 305%
Tricare $20,566 362%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 Nw 95Th St, Miami, FL 33150
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals