CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Ascension St Vincent's Clay County

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $8,154
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.44x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Ascension St Vincent's Clay County is $8,154. 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 1.44x the Medicare baseline. Located in 1670 St Vincents Way, Middleburg, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,154

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: $8,154 (144%)
Ins. Median: $8,154 (144% 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
Blue Cross Blue Shield $1,947 - $25,295 34%
Medicaid / KanCare $3,955 70%
Humana $4,520 - $16,012 80%
Bc Advantage Mcr Replacement $4,659 82%
Coventry Mcr Replacement Hmo $4,659 82%
Medicare (plans) $4,659 - $4,752 82%
Research Study Encore Borland-Groover $4,659 82%
Veterans Administration $4,659 82%
Wellcare $4,659 82%
UnitedHealthcare $4,706 - $19,683 83%
Careplus Mcr Replacement $4,752 84%
Cigna $4,752 - $23,700 84%
Aetna $4,799 - $20,477 85%
Inmate Health Care $5,824 103%
Bright Health $6,290 111%
Smarthealth $6,523 115%
Oscar Health Plan $7,455 131%
Employer Direct Healthcare $8,154 144%
90 Degree Benefits $8,387 148%
Avmed Exchange $8,387 148%
Molina Exchange $8,620 152%
Coventry Hmo $8,850 156%
Ambetter / Centene $8,853 156%
North Florida Surgeons $10,000 176%
Occunet $10,483 185%
Avmed Empower $14,888 262%
Northwell Direct $20,000 352%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1670 St Vincents Way, Middleburg, FL 32068
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals