CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Northside Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $6,294
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.11x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Northside Hospital is $6,294. 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 1.11x the Medicare baseline. Located in 1000 Johnson Ferry Road, Ne, Atlanta, GA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,294

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: $6,294 (111%)
Ins. Median: $6,294 (111% 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
Health One Alliance_Ppo $1,150 20%
Blue Cross Blue Shield $3,245 - $13,653 57%
Kaiser $3,538 - $14,063 62%
Aetna $3,841 - $13,926 68%
Phcs $4,403 78%
Northside Health Network $4,623 81%
UnitedHealthcare $4,634 - $13,653 82%
Genex/Priority Care Solutions $6,149 108%
Cigna $6,294 - $14,063 111%
Streamline Imaging $6,917 122%
Corvel Workers Comp $7,302 129%
Employers Choice Network $7,302 129%
Georgia Workers Compensation $7,686 135%
One Call Diagnostics $7,686 135%
Georgia Reproductive Specialists $11,752 207%
Clear Springs Eon Health $13,653 241%
Medicare (plans) $13,653 - $16,676 241%
Va Ccn $13,653 241%
Humana $13,790 243%
Coventry $13,926 245%
Wellcare $14,063 248%
Amerigroup $14,199 250%
Ambetter / Centene $14,336 - $15,254 253%
Caresource $14,336 253%
Clover Health $14,336 253%
Pruitt Health Premier $14,336 253%
Us Dept Of Labor Wc $19,846 350%
Careiq $29,380 518%
Dekalb_Department Of Health $29,380 518%
Fifa $29,380 518%
Rabun County Boc $29,380 518%
Spreemo $29,380 518%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Johnson Ferry Road, Ne, Atlanta, GA 30342
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals