CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Blue Ridge Regional Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $1,944
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.34x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Blue Ridge Regional Hospital is $1,944. 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 0.34x the Medicare baseline. Located in 125 Hospital Drive, Spruce Pine, NC.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,944

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: $1,944 (34%)
Ins. Median: $1,944 (34% 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
Blue Cross Blue Shield $1,723 - $7,310 30%
Aetna $1,860 33%
Apex Health $1,860 33%
United $1,860 33%
Alignment Health $1,897 33%
Devoted Health $1,897 33%
Cigna $1,916 34%
Humana $1,916 - $1,934 34%
Wellcare $1,916 - $7,529 34%
Nhc Advantage $1,934 34%
Healthteam Advantage $1,953 34%
Provider Partners Health Plan $1,953 34%
Troy Healthcare $1,953 34%
Longevity Health Plan $1,990 35%
Amerihealth Caritas $2,120 37%
Vaya Health $7,529 133%
Amerihealth $7,602 134%
Partners Health Management $7,676 135%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 125 Hospital Drive, Spruce Pine, NC 28777
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals