CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Hialeah Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $8,633
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.52x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Hialeah Hospital is $8,633. 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 1.52x the Medicare baseline. Located in 651 E 25Th St, Hialeah, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,633

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: $8,633 (152%)
Ins. Median: $8,633 (152% 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
Seasons Hospice And Pallative Care Of Southern Florida Inc $904 16%
Bristol Hospice- Miami Dade Llc $988 17%
Catholic Hospice $988 17%
Comprehensive Home Health Care Dba Opuscare Of South Florida $988 17%
Hcr Manor Care Services Of Fl $988 17%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $988 17%
Vitas Healthcare Hospice Corporation Of Fl $988 17%
Hospice Other $1,091 19%
Aetna $2,169 - $8,633 38%
Dimension Health Wc $2,283 40%
Workers Compensation $2,283 40%
Humana $3,599 - $8,460 63%
Bc/Bs Of Fl Miami Dade Blue Select $4,463 79%
Bc/Bs Myblue Hmo Hix $5,936 105%
Bc/Bs Of Fl Health Options Hmo $5,936 105%
Bc/Bs Of Fl Simplyblue $5,936 105%
Veterans Administration Mill Bill $6,043 106%
UnitedHealthcare $7,365 - $14,425 130%
Oscar Health Plan Hix $7,404 130%
Cigna $7,413 - $9,754 131%
Bc/Bs Of Fl Network Blue $7,770 137%
Medicare (plans) $8,201 - $18,866 144%
Molina Marketplace Program Exchange $8,420 148%
Bc/Bs Of Fl Blue Select Exchange Non Par $8,547 151%
Bc/Bs Of Fl Phs $8,550 151%
Bc/Bs Of Fl Ppo $8,550 151%
Leon Health Inc $8,599 152%
Devoted Health $8,633 152%
Veterans Administration Vaccn $8,775 155%
Florida Pace Centers $9,064 160%
Healthsun Health Plans $9,064 160%
Longevity Health Plan $9,170 162%
Avmed Broad Network $9,335 164%
Bright Health Management Commercial $10,530 186%
Self Pay/Uninsured $10,791 190%
Employer Direct Healthcare $10,968 193%
Imagine Health $11,559 204%
Naphcare Inc $12,086 213%
Avmed Exchange $15,356 271%
Ambetter / Centene $16,233 286%
Auto Insurance $17,550 309%
Avmed Select Network $17,956 316%
Amerihealth Caritas Next Exchange $18,866 332%
Tricare $20,566 362%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 E 25Th St, Hialeah, FL 33013
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals