CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: HCA Houston Healthcare Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $7,512
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.32x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at HCA Houston Healthcare Medical Center is $7,512. 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 1.32x the Medicare baseline. Located in 1313 Hermann Dr, Houston, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$7,512

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: $7,512 (132%)
Ins. Median: $7,512 (132% 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 Advantage $995 - $7,732 18%
American Health Plan $1,275 - $7,732 22%
Coventry National First Health $1,941 - $2,855 34%
Oscar $2,131 - $8,639 38%
Aetna $2,669 - $5,299 47%
Evry Health $3,241 - $16,207 57%
United $3,293 - $7,298 58%
Cigna $6,694 - $16,749 118%
Humana $7,136 - $11,437 126%
Wellmed $7,291 128%
Blue Cross Blue Shield $7,364 - $12,195 130%
Triwest Healthcare Alliance $7,364 130%
Van Lang Ipa $7,438 131%
Devoted Health $7,512 132%
Integranet Amerigroup Ipa $7,512 132%
Provider Partners Health Plan Of Texas $7,512 132%
Texas Independent Health Plan $7,659 135%
Wellcare $7,659 135%
Superior Health Plan $7,732 136%
Shared Health $7,880 139%
Molina $8,027 141%
Verda Health Plan $8,101 143%
Healthcare Highways $9,485 167%
Curative Administrators $10,640 187%
Community Health Choice $10,678 188%
Superior $11,415 201%
Molina Healthcare $11,488 202%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1313 Hermann Dr, Houston, TX 77004
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals