CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Piedmont Rockdale Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $9,367
Cash Discount Price: $10,883
vs. Medicare Baseline: 1.65x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Piedmont Rockdale Hospital is $9,367. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,883. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.65x the Medicare baseline. Located in 1412 Milstead Avenue, Ne, Conyers, GA.

Cash / Self-Pay

$10,883

Average discount available for prompt cash payment at this facility.

Insurance Median

$9,367

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: $10,883 (192%)

Insurance Median: $9,367 (165%)

Cash: $10,883 (192% of Medicare)

Ins. Median: $9,367 (165% 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
Phcs [10601]	$1,900	33%
Beechstreet [10800]	$2,100	37%
Multiplan [10600]	$2,100	37%
Medicare (plans)	$8,693 - $9,031	153%
UnitedHealthcare	$8,820 - $14,930	155%
Clear Spring Health Care [30192]	$8,946	158%
Georgia Health Advantage [30143]	$9,031	159%
Ambetter / Centene	$11,315	199%
Aetna	$12,441	219%
Cigna	$12,474 - $18,520	220%
Alliant Health Plans Of Georgia [10952]	$15,476	273%
Blue Cross Blue Shield	$16,687 - $17,456	294%
Alliant Solocare [11101]	$17,185	303%
Caresource Marketplace [11106]	$18,145	320%

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 $10,883.
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 Rockdale 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.