CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Myrtue Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $7,242
Cash Discount Price: $4,421
vs. Medicare Baseline: 1.28x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Myrtue Medical Center is $7,242. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,421. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.28x the Medicare baseline. Located in 1213 Garfield Avenue, Harlan, IA.

Cash / Self-Pay

$4,421

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,242

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: $4,421 (78%)

Insurance Median: $7,242 (128%)

Cash: $4,421 (78% of Medicare)

Ins. Median: $7,242 (128% 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
Wellmark Hmo	$4,345	77%
Wellmark Ppo - All Other Plans	$4,345	77%
Iowa Total Care Mcaid - All Plans	$5,584	98%
Midlands Choice-All Plans	$6,708	118%
Aetna	$7,242	128%
UnitedHealthcare	$7,242 - $7,254	128%
Coventry Mcr - All Plans	$7,254	128%
Amerigroup Mcaid - All Plans	$12,510	220%

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 $4,421.
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 Myrtue Medical Center 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.