CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Coral Gables Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $7,348
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.29x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Coral Gables Hospital is $7,348. 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 1.29x the Medicare baseline. Located in 3100 Douglas Rd, Coral Gables, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$7,348

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: $7,348 (129%)
Ins. Median: $7,348 (129% 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 Palliative Care Of Southern Florida Inc $904 16%
Opus Care Of South Florida $1,060 19%
Catholic Hospice $1,091 19%
Hcr Manor Care Services Of Fl Ii Dba Heartland Hospice Services $1,091 19%
Hospice Other $1,091 19%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $1,091 19%
Vitas Healthcare Corporation/Hospice Ppo $1,091 19%
Aetna $2,169 - $7,348 38%
Dimension Health Wc $2,283 40%
Workers Compensation $2,283 40%
Humana $3,350 - $7,202 59%
Bc/Bs Of Fl Miami Dade Blue Select $4,161 73%
Veterans Administration Mill Bill $5,144 91%
Bc/Bs Myblue Hmo Hix $6,039 106%
Bc/Bs Of Fl Health Options Hmo $6,039 106%
Bc/Bs Of Fl Simplyblue $6,039 106%
Bc/Bs Of Fl Network Blue $6,638 117%
UnitedHealthcare $6,758 - $13,683 119%
Medicare (plans) $6,981 - $16,048 123%
Bc/Bs Of Fl Blue Select Exchange Non Par $7,301 129%
Leon Health Inc $7,315 129%
Devoted Health $7,348 129%
Oscar Health Plan Hix $7,356 130%
Cigna $7,413 - $9,754 131%
Veterans Administration Vaccn $7,464 132%
Florida Pace Centers $7,716 136%
Healthsun Health Plans $7,716 136%
Longevity Health Plan $7,800 137%
Molina Marketplace Program Exchange $8,420 148%
Bright Health Management Commercial $8,957 158%
Self Pay/Uninsured $9,186 162%
Employer Direct Healthcare $9,330 164%
Avmed Broad Network $9,968 176%
Bc/Bs Of Fl Phs $10,229 180%
Bc/Bs Of Fl Ppo $10,229 180%
Imagine Health $10,229 180%
Naphcare Inc $10,288 181%
Avmed Exchange $13,062 230%
Ambetter / Centene $13,809 243%
Auto Insurance $14,929 263%
Avmed Select Network $15,285 269%
Amerihealth Caritas Next Exchange $16,048 283%
Tricare $20,566 362%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3100 Douglas Rd, Coral Gables, FL 33134
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals