CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Prisma Health Oconee Memorial Hospital

Billing Code: 392 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$7,707

about 1.4× the $5,676 Medicare rate · typically $6,255–$9,269

modeled estimate · not a bill or quote

What this hospital charges insurers

$7,619

About the fair price

about $88 under the fair price · 1.3× Medicare

Medicare pays $5,676 Fair price $7,707 This hospital $7,619 Cash price $15,515

How we calculate the fair BaseRate →

How this hospital compares to other SC hospitals

Highest price of the 9 SC hospitals we have prices for — worth calling around.

Cheapest $4,632 Priciest $7,619

Black dot = this hospital, among the 9 SC hospitals with a price for this procedure. Full list below.

A fair price for a Digestive disorders treatment (inpatient stay) is about $7,707 (about 1.4× the $5,676 Medicare rate). Prisma Health Oconee Memorial Hospital charges insurers about $7,619, or about $15,515 in cash — about the fair price. Located in Seneca, SC.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$2,031 - $19,849	36%
Blue Cross Blue Shieldmajor	$5,063 - $12,988	89%
Aetnamajor	$7,273	128%
Cignamajor	$6,927 - $15,923	122%
Humanamajor	$5,343 - $5,448	94%
Ambetter (Centene)	$19,114	337%
Molina	$7,619	134%
MVP Health Care	$15,923	281%
WellCare	$7,273	128%
+ 16 smaller / regional plans	$6,038 - $22,508

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 15,515), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 392.

Insurance Before you use insurance

Call your insurance company to confirm Prisma Health Oconee Memorial Hospital is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 392.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Prisma Health Oconee Memorial Hospital

Compare: Digestive disorders treatment (inpatient stay) at other SC hospitals

Anmed Health · Anderson $4,632
Cannon Memorial Hospital · Pickens $4,726
McLeod Loris Hospital · Loris $5,377
MUSC Health Black River Medical Center · Cades $5,430
Cherokee Medical Center · Gaffney $5,581
Aiken Regional Medical Center · Aiken $5,646
East Cooper Medical Center · Mount Pleasant $6,207
Coastal Carolina Hospital · Hardeeville $6,320

Insurance negotiated median for the same procedure, sorted lowest first.