CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Dlp Swain County Hospital LLC

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $2,235
  • Cash Discount Price: $8,353
  • vs. Medicare Baseline: 0.39x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Dlp Swain County Hospital LLC is $2,235. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,353. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 0.39x the Medicare baseline. Located in 45 Plateau Street, Bryson City, NC.
Cash / Self-Pay
$8,353

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,235

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%)
Cash / Self-Pay: $8,353 (147%)
Insurance Median: $2,235 (39%)
Cash: $8,353 (147% of Medicare)
Ins. Median: $2,235 (39% 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
Advantra $2,235 39%
Aetna $2,235 39%
American Progressive $2,235 39%
Americas First Choice $2,235 39%
Blue Cross Blue Shield $2,235 - $8,514 39%
Care Improvement $2,235 39%
Care Plus $2,235 39%
Citrus $2,235 39%
Evercare $2,235 39%
Health Markets $2,235 39%
Healthnet $2,235 39%
Medical Mutual $2,235 39%
Medicare (plans) $2,235 39%
Physicians $2,235 39%
Pyramid $2,235 39%
Sterling $2,235 39%
Unicare $2,235 39%
UnitedHealthcare $2,235 - $12,103 39%
Wellcare $2,235 39%
Wellpath $2,235 39%
Windsor Health $2,235 39%
Zickgraf $2,235 39%
Ambetter / Centene $5,374 95%
Cigna $7,570 133%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 45 Plateau Street, Bryson City, NC 28713
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals