CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Knox Community Hospital

Billing Code: 392 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$6,695

about 1.2× the $5,676 Medicare rate · typically $5,596–$9,634

modeled estimate · not a bill or quote

What this hospital charges insurers

$5,569

Below the fair price — a good deal

about $1,126 under the fair price · 1.0× Medicare

Medicare pays $5,676 Fair price $6,695 This hospital $5,569

How we calculate the fair BaseRate →

How this hospital compares to other OH hospitals

Highest price of the 9 OH hospitals we have prices for — worth calling around.

Cheapest $2,859 Priciest $5,569

Black dot = this hospital, among the 9 OH hospitals with a price for this procedure. Full list below.

A fair price for a Digestive disorders treatment (inpatient stay) is about $6,695 (about 1.2× the $5,676 Medicare rate). Knox Community Hospital charges insurers about $5,569 — below the fair price — a good deal. Located in Mount Vernon, OH.

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✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser 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	$5,596	99%
Blue Cross Blue Shieldmajor	$5,652	100%
Aetnamajor	$5,541	98%
Humanamajor	$5,541	98%
CareSource	$5,818	103%
Medical Mutual	$4,710	83%
Molina	$5,541	98%
+ 1 smaller / regional plan	$5,596

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, 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 Knox Community Hospital 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 Knox Community Hospital

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

Mercy Health - Urbana Hospital · Urbana $2,859
Mercy Allen Hospital · Oberlin $2,878
Mount Carmel East & West · Columbus $2,921
Diley Ridge Medical Center · Canal Winchester $2,921
Fulton County Health Center · Wauseon $3,508
Mount Carmel New Albany Surgical Hospital · New Albany $4,782
Cincinnati Children's Hospital Medical Center · Cincinnati $5,103
Medina Hospital · Medina $5,212

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