CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: North Carolina Baptist Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $11,676
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.06x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at North Carolina Baptist Hospital is $11,676. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 2.06x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$11,676

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%)
Insurance Median: $11,676 (206%)
Ins. Median: $11,676 (206% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 206% of the Medicare baseline (a markup of 106%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Amerihealth $7,637 - $7,872 135%
Carolina Complete $7,637 135%
Health Blue $7,637 135%
Partners $7,637 135%
Vaya $7,713 136%
UnitedHealthcare $7,714 - $13,338 136%
Wellcare $7,714 - $13,338 136%
Alliance $7,790 137%
Blue Cross Blue Shield $7,846 - $13,338 138%
Trillium $7,866 139%
Ambetter / Centene $8,153 144%
Cigna $11,509 - $13,338 203%
Aetna $13,338 235%
Apex $13,338 235%
Devoted $13,338 235%
Healthteam $13,338 235%
Humana $13,472 237%
Medicare (plans) $13,472 237%
Liberty $15,339 270%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Medical Center Boulevard, Winston-Salem, NC 27157
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals