CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Cape Fear Valley Hoke Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $10,134
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.79x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Cape Fear Valley Hoke Hospital is $10,134. 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 1.79x the Medicare baseline. Located in 210 Medical Pavilion Drive, Raeford, NC.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$10,134

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: $10,134 (179%)

Ins. Median: $10,134 (179% 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
Blue Cross Blue Shield	$1,700	30%
Wellcare	$1,700 - $12,095	30%
Longevity	$5,522 - $10,110	97%
Medicare (plans)	$5,522 - $10,110	97%
Aetna	$5,633 - $25,275	99%
First Carolina Care	$5,633 - $10,312	99%
Liberty Advantage	$5,633 - $10,312	99%
UnitedHealthcare	$5,633 - $12,095	99%
New Hanover	$5,798 - $10,615	102%
Humana	$6,074 - $11,121	107%
Cigna	$9,868	174%
Multiplan	$10,159	179%
Troy	$10,312	182%
Ambetter / Centene	$11,045 - $20,220	195%
Carolina Complete Health	$12,095	213%
Healthy Blue	$12,095	213%

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 Cape Fear Valley Hoke Hospital 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.