CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Sartori Memorial Hospital, Inc

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $8,905
  • Cash Discount Price: $16,183
  • vs. Medicare Baseline: 1.57x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Sartori Memorial Hospital, Inc is $8,905. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16,183. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.57x the Medicare baseline. Located in 515 College Street, Cedar Falls, IA.
Cash / Self-Pay
$16,183

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,905

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: $16,183 (285%)
Insurance Median: $8,905 (157%)
Cash: $16,183 (285% of Medicare)
Ins. Median: $8,905 (157% 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
Aetna $5,178 - $8,932 91%
Medicare (plans) $5,178 - $5,390 91%
Blue Cross Blue Shield $5,230 92%
UnitedHealthcare $5,282 - $11,692 93%
Iowa Total Care $5,883 104%
Medicaid / KanCare $5,941 - $5,964 105%
Oscar $6,861 121%
Amish Hospital Aid $7,028 124%
Centivo $8,772 155%
Ambetter / Centene $8,877 156%
Allied Benefit Systems $8,932 157%
Asr Health Benefits $8,932 157%
Coventry $8,932 157%
First Health $8,932 157%
Lucent Health $8,932 157%
Luminare Health $8,932 157%
Medical Mutual $8,932 157%
Meritain $8,932 157%
Webtpa $8,932 157%
Claimdoc $10,621 187%
Nova $10,621 187%
Geha $11,692 206%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 515 College Street, Cedar Falls, IA 50613
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals