CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Wooster Community Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $9,791
  • Cash Discount Price: $12,013
  • vs. Medicare Baseline: 1.73x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Wooster Community Hospital is $9,791. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12,013. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.73x the Medicare baseline. Located in 1761 Beall Avenue, Wooster, OH.
Cash / Self-Pay
$12,013

Average discount available for prompt cash payment at this facility.

Insurance Median
$9,791

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%)
Cash / Self-Pay: $12,013 (212%)
Insurance Median: $9,791 (173%)
Cash: $12,013 (212% of Medicare)
Ins. Median: $9,791 (173% 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
Tricare $4,855 86%
Aetna $5,455 - $10,692 96%
Aultcare/Primecare Mcr Adv $5,455 96%
Blue Cross Blue Shield $5,455 - $11,052 96%
Buckeye Mcare $5,455 96%
Caresource Mcr Adv $5,455 96%
Humana $5,455 - $11,293 96%
Med Mutual Of Oh Mcr $5,455 96%
Molina Mcr $5,455 96%
Summacare Mcr $5,455 96%
UnitedHealthcare $5,455 - $11,413 96%
Valor Hp Mcr-All Plans $5,455 96%
Buckeye Mcaid-All Other Plans $6,127 108%
Caresource Mcaid $6,127 108%
Molina Mcaid $6,249 110%
Amerihealth Mcaid-All Plans $6,433 113%
The Health Plan Mcr Adv $6,808 120%
Magnipower-All Plans $7,091 125%
Caresource Exch - All Other Plans $7,800 137%
Cerco-All Plans $8,409 148%
Rayco-All Plans $9,010 159%
Molina Marketplace - All Other Plans $9,273 163%
Christian Health Ministries-All Plans $9,611 169%
Cigna $9,611 169%
Health Ohio Network Employer $9,611 169%
Wayne County-All Plans $9,611 169%
Healthsmart Accel $9,971 176%
Healthsmart Complete Ppo-All Other Plans $9,971 176%
Summacare Preferred Choice $9,971 176%
Aultcare/Primetime Exch $10,211 180%
Health Ohio Network Ppo-All Other Plans $10,211 180%
Ohio Health Choice Supp $10,211 180%
Ohio Health Group Hlthy - All Other Plans $10,211 180%
Aultcare Wayne County $10,545 186%
Ohio Health Group Pref $10,692 188%
Aultcare/Primetime-All Other Plans $10,812 190%
Healthsmart Ppo $10,932 193%
Summacare-All Other Plans $11,173 197%
Ohio Health Choice-All Other Plans $11,293 199%
Health Plan Of Upper Ohio-All Plans $11,388 201%
Healthsmart Hpo $11,413 201%
Osu-All Plans $11,413 201%
The Health Plan Comm - All Other Plans $11,428 201%
Central Benefits-All Plans $11,533 203%
First Health-All Plans $11,533 203%
Flora-All Plans $11,533 203%
Beech Street-All Plans $11,653 205%
Phcs-All Plans $11,653 205%
Med Mutual Of Oh Supermed $12,550 221%
Med Mutual Of Oh Exchange $15,685 276%
Med Mutual Of Oh Trad-All Other Plans $17,392 306%
Clarity Health - All Plans $362,445 6386%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1761 Beall Avenue, Wooster, OH 44691
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals