CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Atrium Health Pineville

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $10,476
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.85x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Atrium Health Pineville is $10,476. 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 1.85x the Medicare baseline. Located in 10628 Park Rd, Charlotte, NC.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$10,476

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: $10,476 (185%)

Ins. Median: $10,476 (185% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Humana	$6,266	110%
Aetna	$6,358	112%
Cigna	$6,450 - $13,966	114%
UnitedHealthcare	$6,469 - $9,874	114%
Ambetter / Centene	$8,385 - $10,557	148%
Amerihealth Caritas	$10,282	181%
Alliance	$10,384	183%
Carolina Complete Health	$10,476	185%
Healthy Blue	$10,476	185%
Partners	$10,476	185%
Wellcare	$10,476	185%
Vaya	$10,580	186%
Trillium	$10,790	190%
Blue Cross Blue Shield	$11,919 - $15,683	210%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 392.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Atrium Health Pineville is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 392.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.