CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Presence Mercy Medical Center

Billing Code: 392 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$8,180

about 1.4× the $5,676 Medicare rate · typically $6,355–$9,855

modeled estimate · not a bill or quote

What this hospital charges insurers

$7,869

About the fair price

about $311 under the fair price · 1.4× Medicare

Medicare pays $5,676 Fair price $8,180 This hospital $7,869 Cash price $7,639

How we calculate the fair BaseRate →

How this hospital compares to other IL hospitals

Highest price of the 9 IL hospitals we have prices for — worth calling around.

Cheapest $4,941 Priciest $7,869

Black dot = this hospital, among the 9 IL hospitals with a price for this procedure. Full list below.

A fair price for a Digestive disorders treatment (inpatient stay) is about $8,180 (about 1.4× the $5,676 Medicare rate). Presence Mercy Medical Center charges insurers about $7,869, or about $7,639 in cash — about the fair price. Located in Aurora, IL.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$7,640	135%
Blue Cross Blue Shieldmajor	$7,258 - $11,174	128%
Aetnamajor	$7,640 - $12,624	135%
Cignamajor	$6,709 - $7,640	118%
Humanamajor	$7,640 - $8,404	135%
Ambetter (Centene)	$12,377	218%
Devoted Health	$7,640	135%
Health Net	$9,168	162%
Meridian	$8,022	141%
Molina	$7,869 - $11,460	139%
WellCare	$7,640	135%
+ 8 smaller / regional plans	$7,640 - $11,842

Government programs also on file: Medicare, Military & VA.

Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 7,639), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 392.

Insurance Before you use insurance

Call your insurance company to confirm Presence Mercy Medical Center is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 392.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Presence Mercy Medical Center

Compare: Digestive disorders treatment (inpatient stay) at other IL hospitals

Insurance negotiated median for the same procedure, sorted lowest first.