CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Transylvania Regional Hospital, Inc

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $2,004
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.35x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Transylvania Regional Hospital, Inc is $2,004. 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 0.35x the Medicare baseline. Located in 90 Hospital Drive Po Box 1116, Brevard, NC.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,004

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: $2,004 (35%)
Ins. Median: $2,004 (35% 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
Carepartners Hospice $1,527 27%
Aetna $1,909 34%
Apex Health $1,909 34%
Alignment Health $1,947 34%
Devoted Health $1,947 34%
Cigna $1,966 35%
Humana $1,966 - $1,985 35%
Wellcare $1,966 - $8,098 35%
Nhc Advantage $1,985 35%
Healthteam Advantage $2,004 35%
Provider Partners Health Plan $2,004 35%
Pruitthealth Premier $2,004 35%
Troy Healthcare $2,004 35%
Blue Cross Blue Shield $2,021 - $7,862 36%
Longevity Health Plan $2,043 36%
Amerihealth Caritas $2,176 38%
United $2,408 42%
Vaya Health $8,098 143%
Amerihealth $8,176 144%
Partners Health Management $8,255 145%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 90 Hospital Drive Po Box 1116, Brevard, NC 28712
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals