CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Mercy Health Kings Mills Hospital LLC

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $8,395
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.48x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Mercy Health Kings Mills Hospital LLC is $8,395. 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 1.48x the Medicare baseline. Located in 5440 Kings Island Drive, Mason, OH.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,395

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: $8,395 (148%)
Ins. Median: $8,395 (148% 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
UnitedHealthcare $5,390 - $14,784 95%
Devoted Health Plan [4501] $5,416 95%
Humana $5,416 95%
Medicare (plans) $5,416 95%
Medigold [4435] $5,416 95%
Paramount Elite [3723] $5,416 95%
Caresource Mycare Ohio [4236] $5,525 97%
Buckeye Mycare Benefits [4237] $5,687 100%
Blue Cross Blue Shield $6,229 - $11,641 110%
Caresource [4179] $7,854 138%
Buckeye [4178] $8,395 148%
Cigna $11,535 203%
Medical Mutual [3067] $14,310 252%
Aetna $15,273 269%
Meritain Health [3068] $15,273 269%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5440 Kings Island Drive, Mason, OH 45040
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals