CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Ascension St Vincent's Riverside

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $7,433
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.31x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Ascension St Vincent's Riverside is $7,433. 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 1.31x the Medicare baseline. Located in 1 Shircliff Way, Jacksonville, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,433

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: $7,433 (131%)

Ins. Median: $7,433 (131% 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.

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
Blue Cross Blue Shield	$2,172 - $24,918	38%
Medicaid / KanCare	$3,955	70%
Humana	$4,578 - $16,012	81%
Bc Advantage Mcr Replacement	$4,719	83%
Coventry Mcr Replacement Hmo	$4,719	83%
Heartland Of Hc	$4,719	83%
Medicare (plans)	$4,719 - $4,814	83%
Pace Place	$4,719	83%
Research Study Encore Borland-Groover	$4,719	83%
Veterans Administration	$4,719	83%
Wellcare	$4,719	83%
UnitedHealthcare	$4,766 - $19,683	84%
Careplus Mcr Replacement	$4,814	85%
Cigna	$4,814 - $23,700	85%
Aetna	$4,861 - $19,258	86%
Bright Health	$6,371	112%
Smarthealth	$6,607	116%
Coventry Ppo High Performance	$7,266	128%
Oscar Health Plan	$7,551	133%
Employer Direct Healthcare	$8,259	146%
90 Degree Benefits	$8,495	150%
Avmed Exchange	$8,495	150%
Molina Exchange	$8,731	154%
Coventry Hmo	$8,850	156%
Ambetter / Centene	$8,967	158%
North Florida Surgeons	$10,000	176%
Occunet	$10,618	187%
Avmed Empower	$14,888	262%
Northwell Direct	$20,000	352%

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 $X.
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 Ascension St Vincent's Riverside 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.