CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Palmetto General Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $8,428
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.48x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Palmetto General Hospital is $8,428. 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 1.48x the Medicare baseline. Located in 2001 W 68Th St, Hialeah, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,428

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: $8,428 (148%)
Ins. Median: $8,428 (148% 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

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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
Compassionate Care Hospice Of Miami Dade And The Fl Keys Inc $690 12%
Seasons Hospice And Pallative Care Of Southern Florida Inc $904 16%
Bristol Hospice- Miami Dade Llc $1,091 19%
Catholic Hospice $1,091 19%
Hospice Other $1,091 19%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $1,091 19%
Vitas Healthcare Hospice $1,091 19%
Aetna $2,169 - $8,428 38%
Dimension Health Wc $2,283 40%
Workers Compensation $2,283 40%
Bc/Bs Of Fl Miami Dade Blue Select $4,725 83%
Humana $5,349 - $8,270 94%
Veterans Administration Mill Bill $6,057 107%
Bc/Bs Myblue Hmo Hix $6,459 114%
Bc/Bs Of Fl Health Options Hmo $6,459 114%
Bc/Bs Of Fl Simplyblue $6,459 114%
Bc/Bs Of Fl Network Blue $7,385 130%
Cigna $7,413 - $9,754 131%
Medicare (plans) $7,749 - $17,805 137%
Oscar Health Plan Hix $8,065 142%
Bc/Bs Of Fl Blue Select Exchange Non Par $8,124 143%
UnitedHealthcare $8,316 - $16,995 147%
Leon Health Inc $8,405 148%
Molina Marketplace Program Exchange $8,420 148%
Devoted Health $8,428 148%
Ima Evalutations Inc $8,566 151%
Opuscare Of South Fl $8,566 151%
Veterans Administration Vaccn $8,566 151%
Westchester General Hospital $8,566 151%
Florida Pace Centers $8,823 155%
Healthsun Health Plans $8,823 155%
Longevity Health Plan $8,968 158%
Bright Health Management Commercial $10,173 179%
Avmed Broad Network $10,213 180%
Bc/Bs Of Fl Phs $10,224 180%
Bc/Bs Of Fl Ppo $10,224 180%
Self Pay/Uninsured $10,535 186%
Employer Direct Healthcare $10,575 186%
Imagine Health $11,137 196%
Naphcare Inc $11,590 204%
Avmed Exchange $14,592 257%
Ambetter / Centene $15,395 271%
Auto Insurance $16,068 283%
Avmed Select Network $16,965 299%
Amerihealth Caritas Next Exchange $17,805 314%
Tricare $20,566 362%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2001 W 68Th St, Hialeah, FL 33016
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals