CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: The Medical Center of Southeast Texas

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $7,221
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.27x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at The Medical Center of Southeast Texas is $7,221. 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 1.27x the Medicare baseline. Located in 2555 Jimmy Johnson Blvd, Port Arthur, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$7,221

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: $7,221 (127%)
Ins. Median: $7,221 (127% 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
Heart To Heart Hospice $648 11%
Aetna $855 - $2,307 15%
Harbor Hospice $1,095 19%
Hospice $1,095 19%
Rice Land Hospice $1,095 19%
First Health $1,146 20%
Medicaid / KanCare $1,174 21%
Healthsmart $1,200 21%
Iasis Employees $1,842 32%
UnitedHealthcare $3,838 - $9,169 68%
Humana $3,861 - $6,969 68%
Blue Cross Blue Shield $4,183 - $7,221 74%
Cigna $6,492 - $7,022 114%
Amerigroup $7,221 127%
Healthspring $7,221 127%
Medicare (plans) $7,221 127%
Selectcare $7,221 127%
Superior Healthplan $7,221 127%
Caresact $7,335 129%
Triwest $7,335 129%
Molina Healthcare $7,366 - $9,903 130%
Provider Partners Health Plan $7,366 130%
Tihp (Texas Independence Health Plan) $7,366 130%
Cccn Pro Advantage $7,582 134%
Wellcare Of Texas $7,582 134%
League Medical Concepts $7,944 140%
Wellpath $8,647 152%
Community Health Choice $8,803 155%
Employer Direct Healthcare $9,169 162%
Texas Medical Management Partners $9,169 162%
Texas Workers Compensation $10,490 185%
Corporate Remedies $10,832 191%
Private Healthcare Systems $12,287 216%
Elap Services $14,226 251%
Tricare $23,504 414%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2555 Jimmy Johnson Blvd, Port Arthur, TX 77640
  • CMS Rating: ★★★☆☆
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals