CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Medical City Plano

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $8,011
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.41x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Medical City Plano is $8,011. 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 1.41x the Medicare baseline. Located in 3901 W 15Th St, Plano, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,011

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: $8,011 (141%)
Ins. Median: $8,011 (141% 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
Procare Advantge $995 - $8,011 18%
Healthsmart Preferred Care $1,126 20%
Blue Cross Blue Shield $1,197 - $16,073 21%
American Health Plan Of Texas, Inc. $1,275 - $8,011 22%
Oscar $1,575 - $8,295 28%
Aetna $2,599 - $7,819 46%
United $3,009 - $10,233 53%
Humana $7,477 - $22,983 132%
Wellmed $7,607 134%
Amerigroup $7,630 134%
Integranet $7,630 134%
Triwest Veterans $7,630 134%
Wellcare $7,630 134%
Care N Care $7,706 136%
Cigna $7,782 - $25,487 137%
Devoted Health $7,782 137%
Mutual Of Omaha $7,782 137%
Provider Partners Health Plan $7,782 137%
Texas Independent Health Plan $7,782 137%
Superior Health Plan $8,011 141%
Imperial Insurance Company $8,088 142%
Universal Healthcare Group $8,240 145%
Molina $8,316 147%
Verda Health Plan $8,393 148%
Bravo Health $8,469 149%
Multiplan Phcs $8,513 150%
Fidelis Securecare $8,622 152%
Healthcare Highways $9,959 175%
Usa Managed Care $10,365 183%
Curative Administrators $10,640 187%
Corvel Corporation $10,801 190%
Evry Health $11,012 194%
Superior $13,657 - $17,091 241%
Molina Healthcare $13,664 241%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3901 W 15Th St, Plano, TX 75075
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals