CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: The McDowell Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $8,926
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.57x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at The McDowell Hospital is $8,926. 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 1.57x the Medicare baseline. Located in 430 Rankin Drive P O Box 730, Marion, NC.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,926

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: $8,926 (157%)
Ins. Median: $8,926 (157% 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 $8,204 145%
Vaya Health $8,450 149%
Wellcare $8,450 - $8,926 149%
Amerihealth $8,532 150%
Partners Health Management $8,614 152%
United $8,640 - $8,666 152%
Aetna $8,839 156%
Alignment Health $8,839 156%
Devoted Health $8,839 156%
Humana $8,926 - $9,012 157%
Cigna $9,012 159%
Healthteam Advantage $9,099 160%
Provider Partners Health Plan $9,099 160%
Troy Healthcare $9,099 160%
Apex Health $9,186 162%
Longevity Health Plan $9,272 163%
Nhc Advantage $9,272 163%
Amerihealth Caritas $9,879 - $13,279 174%
Ambetter / Centene $20,529 362%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 430 Rankin Drive P O Box 730, Marion, NC 28752
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals