CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Harris Regional Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $5,947
  • Cash Discount Price: $9,732
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Harris Regional Hospital is $5,947. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,732. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.05x the Medicare baseline. Located in 68 Hospital Rd, Sylva, NC.
Cash / Self-Pay
$9,732

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,947

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: $9,732 (171%)
Insurance Median: $5,947 (105%)
Cash: $9,732 (171% of Medicare)
Ins. Median: $5,947 (105% 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 $5,519 97%
Blue Cross Blue Shield $5,565 - $7,052 98%
Advantra $5,947 105%
Aetna $5,947 105%
American Progressive $5,947 105%
Americas First Choice $5,947 105%
Care Improvement $5,947 105%
Care Plus $5,947 105%
Citrus $5,947 105%
Evercare $5,947 105%
Health Markets $5,947 105%
Healthnet $5,947 105%
Medical Mutual $5,947 105%
Medicare (plans) $5,947 105%
Physicians $5,947 105%
Pyramid $5,947 105%
Sterling $5,947 105%
Unicare $5,947 105%
UnitedHealthcare $5,947 - $11,093 105%
Wellcare $5,947 105%
Wellpath $5,947 105%
Windsor Health $5,947 105%
Zickgraf $5,947 105%
Humana $6,066 107%
Amerihealth Caritas Health Plan $6,979 123%
Cigna $7,570 133%
Caresource $13,381 236%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 68 Hospital Rd, Sylva, NC 28779
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals