CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Sampson Regional Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $6,615
  • Cash Discount Price: $12,402
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Sampson Regional Medical Center is $6,615. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12,402. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.17x the Medicare baseline. Located in 607 Beaman St, Clinton, NC.
Cash / Self-Pay
$12,402

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,615

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: $12,402 (219%)
Insurance Median: $6,615 (117%)
Cash: $12,402 (219% of Medicare)
Ins. Median: $6,615 (117% 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
Healthy Blue Mcaid - All Plans $4,632 82%
Wellcare Mcaid - All Plans $4,632 82%
UnitedHealthcare $4,678 - $7,023 82%
Blue Cross Blue Shield $6,361 112%
Cigna $6,392 113%
Liberty Adv - All Plans $6,488 114%
Aetna $6,615 - $15,946 117%
Gateway Mcr Adv - All Plans $6,615 117%
Medicare (plans) $6,997 123%
Prime/Travelers/Three Rivers - All Plans $6,997 123%
Multiplan - All Plans $7,200 127%
Medcost - All Plans $13,678 241%
Bc Nc Indemnity Ip/Op Only $17,717 312%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 607 Beaman St, Clinton, NC 28328
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals