CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Los Alamos Medical Center

Billing Code: 392 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$7,215

about 1.3× the $5,676 Medicare rate · typically $5,827–$12,349

modeled estimate · not a bill or quote

Medicare pays $5,676 Fair price $7,215 Cash price $19,885 Hospital's list price $33,141

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.

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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	$3,667	65%
Blue Cross Blue Shieldmajor	$10,991 - $11,429	194%
Aetnamajor	$1,736 - $11,429	31%
Cignamajor	$11,429	201%
Humanamajor	$11,429	201%
Molina	$47,552	838%
Presbyterian	$3,433 - $11,429	60%

Government programs also on file: Medicare, Military & VA.

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 19,885), 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 Los Alamos Medical Center 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 Los Alamos Medical Center

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

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