CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: St Luke's Nampa Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $9,247
Cash Discount Price: $28,078
vs. Medicare Baseline: 1.63x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at St Luke's Nampa Medical Center is $9,247. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $28,078. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.63x the Medicare baseline. Located in 9850 West St Lukes Drive, Nampa, ID.

Cash / Self-Pay

$28,078

Average discount available for prompt cash payment at this facility.

Insurance Median

$9,247

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: $28,078 (495%)

Insurance Median: $9,247 (163%)

Cash: $28,078 (495% of Medicare)

Ins. Median: $9,247 (163% 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
Medicare (plans)	$7,310 - $7,456	129%
Blue Cross Blue Shield	$7,383 - $19,515	130%
UnitedHealthcare	$7,675	135%
Commercial [1028]	$7,846 - $19,515	138%
Veterans Affairs [1056]	$7,846	138%
Aetna	$8,041	142%
Mountain Health Co-Op [1067]	$9,247	163%
Pacificsource [1020]	$9,247 - $17,794	163%
Select Health [1063]	$9,247 - $16,933	163%
Slplan Tap Mc St Lukes Health Plan [1641000001]	$9,247 - $16,933	163%
St Lukes Health Plan [1046]	$9,247 - $16,933	163%
Regence [1005]	$18,540 - $19,515	327%
Blue Shield Alt [100401]	$19,515	344%
Regence Out Of State [1004]	$19,515	344%

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 $28,078.
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 St Luke's Nampa 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.