CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Ascension Seton Medical Center Austin

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $5,076
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.89x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Ascension Seton Medical Center Austin is $5,076. 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 0.89x the Medicare baseline. Located in 1201 W 38Th St, Austin, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,076

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: $5,076 (89%)
Ins. Median: $5,076 (89% 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
Tricare $4,279 - $5,076 75%
Aarp Mc Wellmed $4,975 88%
Sendero Chap $5,025 89%
Addr Cancer Together $5,076 89%
Aetna $5,076 89%
Covid Hrsa $5,076 89%
Devoted Health Mcr Replacement $5,076 89%
Humana $5,076 89%
Medicare (plans) $5,076 89%
Research Study $5,076 89%
Smarthealth $5,076 89%
Superior Allwell $5,076 89%
Uhcpcip $5,076 89%
Wellcare Med Advantage $5,076 89%
UnitedHealthcare $5,178 91%
Connected Senior Care $5,228 92%
Pphp Mcr Advantage $5,330 94%
Tx Independence Hp $5,330 94%
Cshcn Cidc $6,150 108%
Occunet $7,107 125%
Sendero Idealcare $8,883 157%
Whole Foods $9,063 160%
Ambetter / Centene $9,137 161%
Oscar Health Exchange $9,379 165%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1201 W 38Th St, Austin, TX 78705
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals