CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Washington County Hospital and Clinics

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $6,716
Cash Discount Price: $7,603
vs. Medicare Baseline: 1.18x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Washington County Hospital and Clinics is $6,716. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,603. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.18x the Medicare baseline. Located in 400 East Polk Street, Washington, IA.

Cash / Self-Pay

$7,603

Average discount available for prompt cash payment at this facility.

Insurance Median

$6,716

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: $7,603 (134%)

Insurance Median: $6,716 (118%)

Cash: $7,603 (134% of Medicare)

Ins. Median: $6,716 (118% 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
Blue Cross Blue Shield	$4,866 - $6,199	86%
Aetna	$5,138 - $8,920	91%
Health Alliance Mcr Adv	$6,138	108%
Med Assoc Mcr Adv	$6,138	108%
Healthpartners Mcr Adv	$6,261	110%
Humana	$6,261	110%
Ia Total Care Wellcare Mcr Adv	$6,322	111%
Wellpoint Mcr Adv Amerigrp - All Other Plans	$6,322	111%
Ia Total Care Mcaid	$7,839	138%
Medicaid / KanCare	$7,839	138%
Wellpoint Mcaid Amerigrp	$7,839	138%
Ambetter / Centene	$8,593	151%
Healthpartners - All Other Plans	$8,616	152%
Midlands Choice - All Plans	$9,123	161%
Molina Mcr Adv - All Other Plans	$9,485	167%
Health Alliance Comm - All Other Plans	$9,630	170%

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 $7,603.
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 Washington County Hospital and Clinics 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.