CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Piedmont Augusta Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $8,538
Cash Discount Price: $8,415
vs. Medicare Baseline: 1.50x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Piedmont Augusta Hospital is $8,538. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,415. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.50x the Medicare baseline. Located in 1350 Walton Way, Augusta, GA.

Cash / Self-Pay

$8,415

Average discount available for prompt cash payment at this facility.

Insurance Median

$8,538

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: $8,415 (148%)

Insurance Median: $8,538 (150%)

Cash: $8,415 (148% of Medicare)

Ins. Median: $8,538 (150% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$4,105 - $18,464	72%
Medicare (plans)	$6,424 - $6,673	113%
UnitedHealthcare	$6,518 - $15,527	115%
Clear Spring Health Care [30192]	$6,611	116%
Georgia Health Advantage [30143]	$6,736	119%
Ambetter / Centene	$9,688	171%
Aetna	$11,595	204%
Caresource Marketplace [11106]	$13,430	237%
First Health [10303]	$16,520	291%
Cigna	$17,594	310%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $8,415.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 392.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Piedmont Augusta Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 392.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.