CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Lexington Memorial Hospital Inc

Billing Code: 392 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$8,337

about 1.5× the $5,676 Medicare rate · typically $6,438–$9,902

modeled estimate · not a bill or quote

What this hospital charges insurers

$7,983

About the fair price

about $354 under the fair price · 1.4× Medicare

Medicare pays $5,676 Fair price $8,337 This hospital $7,983

How we calculate the fair BaseRate →

How this hospital compares to other NC hospitals

Highest price of the 9 NC hospitals we have prices for — worth calling around.

Cheapest $5,175 Priciest $7,983

Black dot = this hospital, among the 9 NC hospitals with a price for this procedure. Full list below.

A fair price for a Digestive disorders treatment (inpatient stay) is about $8,337 (about 1.5× the $5,676 Medicare rate). Lexington Memorial Hospital Inc charges insurers about $7,983 — about the fair price. Located in Lexington, NC.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$4,470 - $8,063	79%
Blue Cross Blue Shieldmajor	$5,715 - $9,179	101%
Aetnamajor	$6,527 - $8,452	115%
Ambetter (Centene)	$5,620	99%
AmeriHealth	$4,909 - $7,983	86%
WellCare	$8,063	142%
+ 6 smaller / regional plans	$7,983 - $8,222

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 392.

Insurance Before you use insurance

Call your insurance company to confirm Lexington Memorial Hospital Inc is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 392.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Lexington Memorial Hospital Inc

Compare: Digestive disorders treatment (inpatient stay) at other NC hospitals

Maria Parham Medical Center · Henderson $5,175
Haywood Regional Medical Center · Clyde $5,287
Sentara Albemarle Medical Center · Elizabeth City $5,497
Wilson Medical Center · Wilson $5,696
Rutherford Regional Medical Center · Rutherfordton $5,902
Harris Regional Hospital · Sylva $5,947
Columbus Regional Healthcare System · Whiteville $6,250
Sampson Regional Medical Center · Clinton $6,488

Insurance negotiated median for the same procedure, sorted lowest first.