CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Holland Community Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $11,130
Cash Discount Price: $14,137
vs. Medicare Baseline: 1.96x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Holland Community Hospital is $11,130. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14,137. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.96x the Medicare baseline. Located in 602 Michigan Ave, Holland, MI.

Cash / Self-Pay

$14,137

Average discount available for prompt cash payment at this facility.

Insurance Median

$11,130

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: $14,137 (249%)

Insurance Median: $11,130 (196%)

Cash: $14,137 (249% of Medicare)

Ins. Median: $11,130 (196% 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
Life Circles-All Plans	$5,209	92%
Health Alliance McR Adv	$5,787	102%
Ph McR Adv	$5,787	102%
UnitedHealthcare	$5,787 - $9,401	102%
VA Ccn - All Plans	$5,787	102%
Aetna	$5,961 - $18,849	105%
Longevity Health Plan-All Plans	$6,250	110%
Molina McAid - All Plans	$9,401	166%
Ph McAid	$9,401	166%
Nomi Health - All Plans	$9,511	168%
Sisco Epi	$11,096	195%
Sisco-All Other Plans	$11,096	195%
Cigna	$11,165	197%
Health Alliance HMO	$12,353	218%
Asr - All Plans	$12,914	228%
Health Alliance Ahl - All Other Plans	$12,914	228%
Blue Cross Blue Shield	$13,048	230%
Priority Health - All Other Plans	$13,171	232%
Cofinity -All Plans	$16,493	291%
Multiplan - All Plans	$20,499	361%
Benefit Source Inc-All Plans	$21,205	374%
First Health-All Plans	$21,205	374%
USA Managed Care-All Plans	$21,205	374%
Integrated Health Plans-All Plans	$22,384	394%

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 $14,137.
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 Holland Community Hospital 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.