CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Ohiohealth Morrow County Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $13,355
  • Cash Discount Price: $10,094
  • vs. Medicare Baseline: 2.35x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Ohiohealth Morrow County Hospital is $13,355. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,094. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 2.35x the Medicare baseline. Located in 651 West Marion Road, Mount Gilead, OH.
Cash / Self-Pay
$10,094

Average discount available for prompt cash payment at this facility.

Insurance Median
$13,355

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: $10,094 (178%)
Insurance Median: $13,355 (235%)
Cash: $10,094 (178% of Medicare)
Ins. Median: $13,355 (235% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 235% of the Medicare baseline (a markup of 135%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Phcs - All Plans $6,000 106%
Medicaid / KanCare $6,554 - $6,685 115%
UnitedHealthcare $6,554 - $17,940 115%
Blue Cross Blue Shield $6,619 - $17,940 117%
Amerihealth Caritas - All Plans $6,750 119%
Humana $6,750 - $17,940 119%
Medical Mutual Of Ohio Marketplace $11,647 205%
Ohiohealthy Network - All Other Plans $11,647 205%
Ohiohealthy Preferred $11,647 205%
Medical Mutual Of Ohio Comm - All Other Plans $12,579 222%
Medical Mutual Of Ohio - Admin Serv $13,200 233%
Aetna $13,355 - $18,299 235%
Cigna $14,598 257%
Multiplan - All Plans $14,753 260%
Healthstar Comm - All Plans $14,908 263%
Beech Street - All Plans $15,064 265%
Medicare (plans) $17,940 - $18,299 316%
Caresource Marketplace - All Other Plans $22,425 395%
Molina Exchange - All Other Plans $28,754 507%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 West Marion Road, Mount Gilead, OH 43338
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals