CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Seiling Municipal Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $4,573
Cash Discount Price: $224,826
vs. Medicare Baseline: 0.81x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Seiling Municipal Hospital is $4,573. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $224,826. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 0.81x the Medicare baseline. Located in 809 Ne Highway 60, Seiling, OK.

Cash / Self-Pay

$224,826

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,573

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: $224,826 (3961%)

Insurance Median: $4,573 (81%)

Cash: $224,826 (3961% of Medicare)

Ins. Median: $4,573 (81% 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
Coventry Comm - All Plans	$1,250	22%
Humana	$1,800 - $4,573	32%
Aetna	$3,373 - $4,573	59%
Soonerselect Mcaid - All Plans	$3,373	59%
Cigna	$3,894	69%
Multiplan Ip/Op Only - All Plans	$3,898	69%
Blue Cross Blue Shield	$4,116 - $9,375	73%
Community Choice Ppo Ip/Op Only - All Plans	$4,179	74%
Preferred Comm Ip/Op Only - All Plans	$4,179	74%
UnitedHealthcare	$4,573 - $4,942	81%
Wellcare Mcr Adv - All Plans	$4,573	81%
Ambetter / Centene	$7,545	133%
Healthchoice Ip/Op Only - All Plans	$9,274	163%

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 $224,826.
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 Seiling Municipal 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.