CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Memorial Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $7,009
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Memorial Hospital is $7,009. 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 1.23x the Medicare baseline. Located in 715 South Taft Avenue, Fremont, OH.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,009

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: $7,009 (123%)

Ins. Median: $7,009 (123% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$1,125 - $8,540	20%
Caresource	$1,692 - $11,379	30%
Health Ohio Network	$1,692	30%
UnitedHealthcare	$2,646 - $6,691	47%
Summacare	$4,288 - $14,829	76%
Blue Cross Blue Shield	$5,838 - $13,213	103%
Paramount Healthcare Inc	$5,881 - $9,959	104%
Humana	$5,946 - $7,481	105%
Molina Healthcare Of Ohio	$5,946 - $12,587	105%
Frontpath	$5,988 - $6,789	105%
Health Alliance Plan	$6,065 - $14,051	107%
Meridian Health Plan Of Mi	$6,075	107%
Buckeye Community Health Plan	$7,334 - $10,858	129%
Amerihealth	$7,585 - $7,999	134%
Medical Mutual Of Ohio	$11,885 - $13,585	209%
Cigna	$12,472 - $13,407	220%
Multiplan	$12,498	220%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 392.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 392.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.