CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Eastern Idaho Regional Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $14,395
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.54x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Eastern Idaho Regional Medical Center is $14,395. 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 2.54x the Medicare baseline. Located in 3100 Channing Way, Idaho Falls, ID.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$14,395

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: $14,395 (254%)

Ins. Median: $14,395 (254% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 254% of the Medicare baseline (a markup of 154%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
United	$6,972 - $11,873	123%
Interwest Health	$7,157	126%
Molina	$7,233	127%
Prime Health	$7,233	127%
Regence Blue Shield	$7,233	127%
Rexburg Care And Rehab	$7,233	127%
Triwest Healthcare Alliance	$7,233	127%
Veteran'S Administration	$7,233	127%
Blue Cross Blue Shield	$7,305 - $18,649	129%
Humana	$7,377	130%
Pacificsource Health	$13,782	243%
Select Health	$15,007	264%
Select Health Ichn Brightpath	$15,424 - $16,569	272%
Select Health Idaho (Eirmc Only)	$16,456	290%
Regence	$17,604	310%
University Of Utah	$18,508	326%
Dmba	$18,563	327%

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 $X.
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 Eastern Idaho Regional 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.