CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Larkin Community Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $6,500
  • Cash Discount Price: $29,903
  • vs. Medicare Baseline: 1.15x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Larkin Community Hospital is $6,500. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $29,903. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.15x the Medicare baseline. Located in 7031 Sw 62Nd Ave, South Miami, FL.
Cash / Self-Pay
$29,903

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,500

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: $29,903 (527%)
Insurance Median: $6,500 (115%)
Cash: $29,903 (527% of Medicare)
Ins. Median: $6,500 (115% 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.

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
Managed Care Concepts Behavioral-All Plans $2,200 39%
Cigna $3,200 - $5,457 56%
Medicare (plans) $3,929 - $6,848 69%
Florida Health Solution/Hmo-All Plans $4,800 85%
Corvel Mcare Workers Comp-All Plans $5,051 89%
Molina Exch Marketplace-All Other Plans $5,051 89%
Blue Cross Blue Shield $5,332 - $10,341 94%
Jmh Health Plan Hmo/Ppo-All Other Plans $5,349 94%
Aetna $5,613 - $9,697 99%
Ambetter / Centene $5,613 99%
First Med Hp Of Fl-All Plans $5,613 99%
Florida Comm Care Mcaid $5,613 99%
Florida Comm Care Mcare-All Other Plans $5,613 99%
Humana $5,613 - $9,697 99%
Odyssey Health Mcare Ip Only $5,613 99%
Ops Maritime-All Plans $5,613 99%
Preferred Care Partners Mcare-All Plans $5,613 99%
UnitedHealthcare $5,613 - $9,697 99%
Clear Springs Hlth-All Plans $5,893 104%
Unicare Simply Mcare Ppo-All Plans $5,893 104%
Careplus Health-All Other Plans $5,950 105%
Healthsun-All Plans $6,062 107%
Wellpath-All Plans $6,174 109%
United Prop Casualty-All Plans $6,471 114%
Doctors Healthcare-All Plans $6,529 115%
Coventry Comml-All Plans $6,735 119%
Global Excel-All Plans $6,735 119%
Guardian Life-All Plans $6,735 119%
Haa Preferred Partners-All Plans $6,735 119%
Medicaid / KanCare $6,788 - $10,184 120%
Centurion-All Plans $6,979 123%
Fci-All Plans $7,016 124%
Bright Health-All Other Plans $7,064 124%
Allianz (Azga)-All Plans $7,296 129%
Federal Detention Center Ip Only-All Plans $7,296 129%
Fdc-All Plans $7,858 138%
Corvel Mcaid Workers Comp $8,727 154%
Community Care Phks Mcaid-All Other Plans $9,697 171%
Magellan Complete Care $9,697 171%
Odyssey Health Mcaid Ip Only $9,697 171%
Star Network-All Plans $17,087 301%
Oscar Health-All Plans $17,776 313%
Odyssey Health Ip Only-All Other Plans $40,583 715%
Avmed-All Plans $42,719 753%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7031 Sw 62Nd Ave, South Miami, FL 33143
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals