CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Northside Hospital Duluth

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $6,636
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Northside Hospital Duluth is $6,636. 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 1.17x the Medicare baseline. Located in 3620 Howell Ferry Road, Duluth, GA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,636

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: $6,636 (117%)
Ins. Median: $6,636 (117% 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
Health One Alliance_Ppo $1,150 20%
Us Dept Of Labor Wc $1,340 24%
Blue Cross Blue Shield $3,245 - $11,601 57%
Kaiser $3,538 - $11,950 62%
Aetna $3,841 - $11,717 68%
Phcs $4,403 78%
Northside Health Network $4,623 81%
UnitedHealthcare $4,634 - $11,601 82%
Champus Va $5,274 93%
Tricare $5,279 93%
Genex/Priority Care Solutions $6,149 108%
Cigna $6,294 - $11,950 111%
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%
Humana $9,729 - $11,717 171%
Coventry $9,825 - $11,833 173%
Wellcare $9,921 - $11,950 175%
Clear Springs Eon Health $10,050 - $11,601 177%
Medicare (plans) $10,050 - $13,922 177%
Va Ccn $10,050 - $11,601 177%
Ambetter / Centene $10,114 - $15,254 178%
Pruitt Health Premier $10,114 - $12,182 178%
Caresource $10,552 186%
Clover Health $10,552 186%
Georgia Reproductive Specialists $11,752 207%
Amerigroup $12,066 - $14,199 213%
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: 3620 Howell Ferry Road, Duluth, GA 30096
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals