CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Mount Carmel New Albany Surgical Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $4,173
  • Cash Discount Price: $15,427
  • vs. Medicare Baseline: 0.74x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Mount Carmel New Albany Surgical Hospital is $4,173. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15,427. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 0.74x the Medicare baseline. Located in 7333 Smith's Mill Road, New Albany, OH.
Cash / Self-Pay
$15,427

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,173

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: $15,427 (272%)
Insurance Median: $4,173 (74%)
Cash: $15,427 (272% of Medicare)
Ins. Median: $4,173 (74% 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
Crime Victim Assistance $632 11%
Ohio Safe Program $632 11%
Hospice Mount Carmel $1,151 20%
Aetna $3,563 - $10,484 63%
Rural Carrier Health Benefit Plan $3,563 63%
UnitedHealthcare $4,782 - $7,902 84%
Geha $7,902 139%
Blue Cross Blue Shield $17,171 303%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7333 Smith's Mill Road, New Albany, OH 43054
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals