CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Presence Mercy Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $7,869
  • Cash Discount Price: $7,639
  • vs. Medicare Baseline: 1.39x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Presence Mercy Medical Center is $7,869. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,639. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.39x the Medicare baseline. Located in 1325 N Highland Avenue, Aurora, IL.
Cash / Self-Pay
$7,639

Average discount available for prompt cash payment at this facility.

Insurance Median
$7,869

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: $7,639 (135%)
Insurance Median: $7,869 (139%)
Cash: $7,639 (135% of Medicare)
Ins. Median: $7,869 (139% 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
Tricare $6,153 108%
Cigna $6,709 - $7,640 118%
Blue Cross Blue Shield $7,258 - $11,174 128%
Advocate Helath Partners $7,640 135%
Aetna $7,640 - $8,022 135%
Celtic (Wellcare) $7,640 135%
Devoted Health $7,640 135%
Harmony Health Plan $7,640 135%
Health Alliance Medical Plan $7,640 135%
Humana $7,640 - $8,404 135%
Longevity Health Plan Of Illinois $7,640 135%
Medicare (plans) $7,640 135%
Self-Pay $7,640 135%
United Behavioral Health $7,640 135%
UnitedHealthcare $7,640 135%
Clear Spring Health Of Illinois $7,716 136%
Molina $7,869 - $11,460 139%
Zing Health Provider Network $7,869 139%
Meridian $8,022 141%
Provider Partners Health Plan (Pphp) $8,022 141%
Access Community Health Network $9,168 162%
Clifton Health Systems $11,842 209%
Hfn Inc (Healthcare Finest Network) $12,358 218%
Ambetter / Centene $12,377 218%
Corvel $12,624 222%
Coventry $12,624 222%
Workers Comp $12,624 222%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1325 N Highland Avenue, Aurora, IL 60506
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals