CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Mercy Hospital Ada

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $6,362
  • Cash Discount Price: $11,707
  • vs. Medicare Baseline: 1.12x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Mercy Hospital Ada is $6,362. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,707. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.12x the Medicare baseline. Located in 430 North Monte Vista, Ada, OK.
Cash / Self-Pay
$11,707

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,362

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: $11,707 (206%)
Insurance Median: $6,362 (112%)
Cash: $11,707 (206% of Medicare)
Ins. Median: $6,362 (112% 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
Aetna $2,993 - $6,362 53%
Humana $2,993 - $6,485 53%
Medicaid / KanCare $2,993 - $8,431 53%
Workers Comp [20426] $4,902 86%
United Medical Resources Contracted [320454] $5,600 99%
UnitedHealthcare $5,600 - $6,362 99%
Osma Health Contracted [320292] $6,262 110%
Blue Cross Blue Shield $6,362 - $13,630 112%
Cherokee Nation Health Serv Contracted [320066] $6,362 112%
Cross Timbers Hospice [20098] $6,362 112%
Dept Of Veteran Affairs Contracted [320106] $6,362 112%
Elara Caring Aspire Hospice Contracted [320433] $6,362 112%
Elara Caring Aspire Hospice [20433] $6,362 112%
Halo Hcr Inc Hospice Contracted [320432] $6,362 112%
Halo Hcr Inc Hospice [20432] $6,362 112%
Independent Health [20197] $6,362 112%
Indian Health Service Contracted [320198] $6,362 112%
Kindful Hospice Contracted [320434] $6,362 112%
Kindful Hospice [20434] $6,362 112%
Medical Associates Health [20444] $6,362 112%
Medicare (plans) $6,362 - $6,485 112%
Mercy Hospice Okc [20252] $6,362 112%
Provider Partners Health Plans Contracted [320450] $6,362 112%
Qual Choice Contracted [320325] $6,362 112%
Tricare $6,362 112%
Globalhealth Contracted [320145] $6,492 114%
Cigna $6,557 116%
Globalhealth Contracted [320144] $7,696 136%
Medica Contracted [320239] $8,231 145%
Ambetter / Centene $8,431 149%
Home State Health Plan Contracted [320187] $8,431 149%
Novasys Contracted [320285] $8,431 149%
Health Choice Contracted [320166] $10,080 178%
Healthsmart Preferred Care Contracted [320184] $14,315 252%
Kempton Contracted [320214] $14,315 252%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 430 North Monte Vista, Ada, OK 74820
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals