CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: HCA Houston Healthcare West

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $11,066
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.95x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at HCA Houston Healthcare West is $11,066. 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 1.95x the Medicare baseline. Located in 12141 Richmond Ave, Houston, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$11,066

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: $11,066 (195%)
Ins. Median: $11,066 (195% 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
Texas Athletic Network $750 13%
Procare Advantage $995 - $11,722 18%
American Health Plan $1,275 - $11,722 22%
Coventry National First Health $1,941 - $2,855 34%
Oscar $2,131 - $10,940 38%
Aetna $2,669 - $11,018 47%
Evry Health $3,241 - $16,207 57%
United $3,293 - $11,063 58%
Cigna $6,694 - $16,749 118%
Averde Health $7,016 124%
Blue Cross Blue Shield $7,333 - $12,195 129%
Imagine Health $7,734 136%
Healthcare Highways $9,485 167%
Curative Administrators $10,640 187%
Humana $10,817 - $11,437 191%
Wellmed $11,068 195%
Amerigroup $11,164 197%
Chc Harris Health $11,164 197%
Integranet Amerigroup Ipa $11,164 197%
Kelsey Seybold $11,164 197%
Texas Healthcare Foundation $11,164 197%
Triwest Healthcare Alliance $11,164 197%
Texas Independent Health Plan $11,275 199%
Van Lang Ipa $11,275 199%
Wellcare $11,275 199%
Devoted Health $11,387 201%
Provider Partners Health Plan Of Texas $11,387 201%
Superior Health Plan $11,722 207%
Shared Health $11,945 210%
Universal Healthcare Group $12,057 212%
Molina Healthcare $12,158 214%
Fidelis Securecare Of Tx $12,168 214%
Molina $12,168 214%
Verda Health Plan $12,280 216%
Corvel Corporation $15,804 278%
Community Health Choice $16,187 285%
Omni Healthcare $16,762 295%
Superior $17,303 305%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12141 Richmond Ave, Houston, TX 77082
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals