CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Highlands Cashiers Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $1,672
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.29x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Highlands Cashiers Hospital is $1,672. 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 0.29x the Medicare baseline. Located in 190 Hospital Drive, Highlands, NC.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,672

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: $1,672 (29%)
Ins. Median: $1,672 (29% 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
Aetna $1,592 28%
Apex Health $1,592 28%
Alignment Health $1,624 29%
Devoted Health $1,624 29%
Cigna $1,640 29%
Humana $1,640 - $1,656 29%
Wellcare $1,640 - $8,436 29%
Nhc Advantage $1,656 29%
Healthteam Advantage $1,672 29%
Provider Partners Health Plan $1,672 29%
Troy Healthcare $1,672 29%
Longevity Health Plan $1,703 30%
Amerihealth Caritas $1,815 32%
Blue Cross Blue Shield $2,010 - $8,190 35%
United $2,010 35%
Vaya Health $8,436 149%
Amerihealth $8,518 150%
Partners Health Management $8,600 152%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 190 Hospital Drive, Highlands, NC 28741
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals