CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Prisma Health Laurens County Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $8,438
  • Cash Discount Price: $16,989
  • vs. Medicare Baseline: 1.49x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Prisma Health Laurens County Hospital is $8,438. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16,989. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.49x the Medicare baseline. Located in 22725 Highway 76 East, Clinton, SC.
Cash / Self-Pay
$16,989

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,438

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: $16,989 (299%)
Insurance Median: $8,438 (149%)
Cash: $16,989 (299% of Medicare)
Ins. Median: $8,438 (149% 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 - $14,148 36%
Humana $5,394 - $5,500 95%
Medicare (plans) $5,394 - $16,649 95%
Blue Cross Blue Shield $8,036 - $15,847 142%
Champva [3049] $8,036 142%
Cigna $8,036 - $15,923 142%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $8,036 142%
Deseret Mutual Ins Co [3066] $8,036 142%
Generic Skilled Nursing [3196] $8,036 142%
Hospice Contracted [1500] $8,036 142%
Hospice Non Contracted [3190] $8,036 142%
Triwest Healthcare Alliance Vcp [902] $8,036 142%
Va Community Care Network-Vaccn [903] $8,036 142%
Veterans Administration [3194] $8,036 142%
Aetna $8,438 149%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $8,438 149%
Healthy Conn Prime-First Choice Vip Care [5300] $8,518 150%
Healthy Conn Prime-Molina Healthcare [5330] $8,839 156%
Sc Dept Of Corrections [2998] $8,998 159%
Scdc-Sc Dept Of Corrections [7232] $8,998 159%
Bob Jones Univ-Pai [821] $10,382 183%
Workers Comp [600] $11,250 198%
Preferred Administrators Contracted [2839] $13,844 244%
Golden Rule Insurance Company [2991] $14,148 249%
Oxford Health Plans [2992] $14,148 249%
Zzumr-Salt Lake City Ut [3169] $14,148 249%
Promise Health Plan Contracted [2401] $15,202 268%
Planned Administrators [820] $15,847 279%
Evernorth Behavioral Contracted [2982] $15,923 281%
Mvp Health Care [3037] $15,923 281%
First Choice Benefits Mgmt [3074] $16,649 293%
Bluechoice [810] $20,857 367%
Ambetter / Centene $21,134 372%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 22725 Highway 76 East, Clinton, SC 29325
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals