CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Carnegie Tri-County Municipal Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $17,508
Cash Discount Price: Unavailable
vs. Medicare Baseline: 3.08x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Carnegie Tri-County Municipal Hospital is $17,508. 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 3.08x the Medicare baseline. Located in 102 North Broadway, Carnegie, OK.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$17,508

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: $17,508 (308%)

Ins. Median: $17,508 (308% 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 308% of the Medicare baseline (a markup of 208%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
UnitedHealthcare	$2,962 - $17,508	52%
Aetna	$3,373 - $17,508	59%
Humana	$3,373 - $17,508	59%
Soonerselect Mcaid - All Plans	$3,373	59%
Blue Cross Blue Shield	$5,663 - $17,508	100%
Health Choice - All Plans	$9,274	163%
Wellcare Mcr Adv - All Plans	$17,508	308%
Community Care Comm Ip/Op Only - All Plans	$18,222	321%
Preferred Comm Ppo - All Plans	$18,222	321%
Global Health Ip/Op Only - All Other Plans	$19,361	341%
First Health - All Plans	$20,500	361%
Multiplan - All Plans	$20,956	369%
Ambetter / Centene	$22,760	401%
Global Health Mcr Adv	$29,141	513%

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 $X.
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 Carnegie Tri-County 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.