CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Prisma Health Hillcrest Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $5,568
  • Cash Discount Price: $14,463
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Prisma Health Hillcrest Hospital is $5,568. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14,463. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 0.98x the Medicare baseline. Located in 741 South East Main Street, Simpsonville, SC.
Cash / Self-Pay
$14,463

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,568

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: $14,463 (255%)
Insurance Median: $5,568 (98%)
Cash: $14,463 (255% of Medicare)
Ins. Median: $5,568 (98% 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
Medicaid / KanCare $2,031 36%
UnitedHealthcare $2,031 - $19,849 36%
Humana $5,212 - $5,314 92%
Medicare (plans) $5,212 - $9,060 92%
Blue Cross Blue Shield $5,303 - $12,919 93%
Champva [3049] $5,303 93%
Cigna $5,303 - $15,923 93%
Deseret Mutual Ins Co [3066] $5,303 93%
Generic Skilled Nursing [3196] $5,303 93%
Hospice Contracted [1500] $5,303 93%
Hospice Non Contracted [3190] $5,303 93%
Veterans Administration [3194] $5,303 93%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $5,376 95%
Triwest Healthcare Alliance Vcp [902] $5,376 95%
Va Community Care Network-Vaccn [903] $5,376 95%
Aetna $5,568 98%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $5,568 98%
Healthy Conn Prime-First Choice Vip Care [5300] $5,621 99%
Healthy Conn Prime-Molina Healthcare [5330] $5,834 103%
Bluechoice [810] $7,177 - $13,199 126%
Workers Comp [600] $7,424 131%
First Choice Benefits Mgmt [3074] $9,060 160%
Sc Dept Of Corrections [2998] $9,160 161%
Scdc-Sc Dept Of Corrections [7232] $9,160 161%
Bob Jones Univ-Pai [821] $10,382 183%
Planned Administrators [820] $12,919 228%
Preferred Administrators Contracted [2839] $13,844 244%
Ambetter / Centene $14,140 249%
Promise Health Plan Contracted [2401] $15,202 268%
Evernorth Behavioral Contracted [2982] $15,923 281%
Mvp Health Care [3037] $15,923 281%
Golden Rule Insurance Company [2991] $19,849 350%
Oxford Health Plans [2992] $19,849 350%
Zzumr-Salt Lake City Ut [3169] $19,849 350%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 741 South East Main Street, Simpsonville, SC 29681
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals