CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Physicians Regional Medical Center - Pine Ridge

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $7,421
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.31x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Physicians Regional Medical Center - Pine Ridge is $7,421. 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 6101 Pine Ridge Road, Naples, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$7,421

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: $7,421 (131%)
Ins. Median: $7,421 (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.

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
Node Non Par Hospice Agree $1,141 20%
Aetna $5,669 - $18,333 100%
Blue Cross Blue Shield $5,669 - $14,085 100%
Humana $5,669 100%
Medicare (plans) $5,669 100%
UnitedHealthcare $5,669 - $9,734 100%
Freedom Optimum $5,838 103%
Node Va $5,864 103%
Node Wellcare Mcr Adv $5,922 104%
Simply Healthcare $5,951 105%
Node Us Dept Of Labor $9,342 165%
Florida State Auto Insurance $11,499 203%
Ambetter / Centene $14,661 258%
Cigna $15,092 266%
Occunet $17,248 304%
Community Health Partners $23,417 413%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6101 Pine Ridge Road, Naples, FL 34119
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals