CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Lexington Medical Center

Billing Code: 392 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$7,435

about 1.3× the $5,676 Medicare rate · typically $6,315–$10,869

modeled estimate · not a bill or quote

What this hospital charges insurers

$8,235

About the fair price

about $800 over the fair price · 1.5× Medicare

Medicare pays $5,676 Fair price $7,435 This hospital $8,235

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 $8,235

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 $7,435 (about 1.3× the $5,676 Medicare rate). Lexington Medical Center charges insurers about $8,235 — about the fair price. Located in West Columbia, 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	$6,862 - $21,410	121%
Blue Cross Blue Shieldmajor	$6,862 - $22,306	121%
Aetnamajor	$7,342	129%
Cignamajor	$24,115	425%
Humanamajor	$7,274	128%
Ambetter (Centene)	$16,469	290%
Molina	$8,235 - $16,263	145%
WellCare	$7,342	129%
+ 3 smaller / regional plans	$7,205 - $26,084

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, 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 Lexington Medical Center 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 Lexington Medical Center

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.