CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Northside Hospital

Billing Code: 392 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$11,535

about 2.0× the $5,676 Medicare rate · typically $6,597–$12,132

modeled estimate · not a bill or quote

What this hospital charges insurers

$13,926

Above the fair price

about $2,391 over the fair price · 2.5× Medicare

Medicare pays $5,676 Fair price $11,535 This hospital $13,926

How we calculate the fair BaseRate →

How this hospital compares to other GA hospitals

Highest price of the 9 GA hospitals we have prices for — worth calling around.

Cheapest $4,585 Priciest $13,926

Black dot = this hospital, among the 9 GA hospitals with a price for this procedure. Full list below.

A fair price for a Digestive disorders treatment (inpatient stay) is about $11,535 (about 2.0× the $5,676 Medicare rate). Northside Hospital charges insurers about $13,926 — above the fair price. Located in Atlanta, GA.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $11,535. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$4,634 - $13,653	82%
Blue Cross Blue Shieldmajor	$3,245 - $13,653	57%
Aetnamajor	$3,841 - $13,926	68%
Cignamajor	$6,294 - $14,063	111%
Humanamajor	$13,790	243%
Kaiser Permanentemajor	$3,538 - $14,063	62%
Ambetter (Centene)	$14,336 - $15,254	253%
Amerigroup	$14,199	250%
CareSource	$14,336	253%
Clover Health	$14,336	253%
Health Net	$4,623	81%
WellCare	$14,063	248%
+ 11 smaller / regional plans	$6,917 - $29,380

Government programs also on file: Medicare, Military & VA.

Excludes 6 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 392.

Insurance Before you use insurance

Call your insurance company to confirm Northside Hospital is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 392.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Northside Hospital

Compare: Digestive disorders treatment (inpatient stay) at other GA hospitals

Coffee Regional Medical Center, Inc · Douglas $4,585
Bacon County Hospital · Alma $5,150
Northside Hospital Forsyth · Cumming $5,767
Phoebe Putney Memorial Hospital · Albany $5,990
Wellstar Paulding Medical Center · Hiram $6,074
Wellstar North Fulton Medical Center · Roswell $6,119
Doctors Hospital · Augusta $7,387
Navicent Health Baldwin · Milledgeville $7,406

Insurance negotiated median for the same procedure, sorted lowest first.