CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: San Juan Regional Medical Center Inc

Billing Code: 392 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$7,682

about 1.4× the $5,676 Medicare rate · typically $6,054–$12,259

modeled estimate · not a bill or quote

Medicare pays $5,676 Fair price $7,682 Cash price $17,477 Hospital's list price $34,953

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Aetna✓ Cigna✓ Humana Blue Cross Blue ShieldKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$4,442 - $26,635	78%
Aetnamajor	$31,458	554%
Cignamajor	$27,222	480%
Humanamajor	$6,428 - $27,963	113%
Health Net	$27,963	493%
Presbyterian	$5,908 - $18,000	104%
+ 7 smaller / regional plans	$5,908 - $27,963

Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 17,477), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 392.

Insurance Before you use insurance

Call your insurance company to confirm San Juan Regional Medical Center Inc is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 392.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at San Juan Regional Medical Center Inc

Compare: Digestive disorders treatment (inpatient stay) at other NM hospitals

Insurance negotiated median for the same procedure, sorted lowest first.