CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Legacy Mount Hood Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $9,803
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.73x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Legacy Mount Hood Medical Center is $9,803. 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 1.73x the Medicare baseline. Located in 24800 Se Stark Street, Gresham, OR.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$9,803

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: $9,803 (173%)
Ins. Median: $9,803 (173% 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
Kaiser $8,831 - $17,663 156%
Atrio $9,096 160%
UnitedHealthcare $9,096 - $17,478 160%
Aetna $9,273 - $21,439 163%
Blue Cross Blue Shield $9,273 - $16,433 163%
Devoted Health $9,273 163%
Humana $9,273 163%
Healthnet $9,361 165%
Careoregon $9,538 168%
Pacificsource $9,538 - $14,883 168%
Ageright $9,714 171%
Cigna $9,714 171%
Providence $9,714 171%
Moda $9,891 - $19,332 174%
Summit Health $9,891 174%
Health 2 Business $14,045 247%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 24800 Se Stark Street, Gresham, OR 97030
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals