CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Woodlawn Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $9,967
  • Cash Discount Price: $16,451
  • vs. Medicare Baseline: 1.76x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Woodlawn Hospital is $9,967. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16,451. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.76x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.
Cash / Self-Pay
$16,451

Average discount available for prompt cash payment at this facility.

Insurance Median
$9,967

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: $16,451 (290%)
Insurance Median: $9,967 (176%)
Cash: $16,451 (290% of Medicare)
Ins. Median: $9,967 (176% 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
Blue Cross Blue Shield $6,288 - $16,670 111%
Caresource Mcaid Hww $6,288 111%
Mdwise Excel Hhw & Hcc $6,288 111%
Mhs Mcaid Hcc $6,288 111%
Mhs Mcaid Hhw $6,288 111%
UnitedHealthcare $6,288 - $16,670 111%
Aetna $8,034 - $20,837 142%
Caresource Mcaid Hip $8,034 142%
Caresource Mcr Adv $8,034 142%
Humana $8,034 - $17,387 142%
Mdwise Mcaid Excel Hip $8,034 142%
Mhs Exch Mrktplce-All Other Plans $8,034 142%
Mhs Mcaid Hip $8,034 142%
Mhs Mcr Adv $8,195 144%
Partners Direct Health-All Plans $10,135 179%
Caresource Exch - All Other Plans $10,444 184%
Ambetter / Centene $10,685 188%
Cigna $15,705 - $18,644 277%
Parkview Health Plans-All Plans $16,450 290%
Sagamore All Other Grps - All Other Plans $18,425 325%
Encore Comm-All Plans $18,644 328%
Phcs/Multiplan-All Plans $20,399 359%
Community Health Alliance-All Plans $20,837 367%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1400 E 9Th St, Rochester, IN 46975
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals