CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: HCA Houston Healthcare Tomball

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $8,325
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.47x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at HCA Houston Healthcare Tomball is $8,325. 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 1.47x the Medicare baseline. Located in 605 Holderrieth, Tomball, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,325

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: $8,325 (147%)
Ins. Median: $8,325 (147% 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 - $8,654 18%
American Health Plan $1,275 - $8,654 22%
Oscar $2,131 - $8,639 38%
Aetna $2,669 - $8,135 47%
Evry Health $3,241 - $16,207 57%
United $3,293 - $8,168 58%
Cigna $6,694 - $16,749 118%
Blue Cross Blue Shield $7,333 - $12,195 129%
Humana $7,987 - $11,437 141%
Wellmed $8,160 144%
Chc Harris Health $8,242 145%
Integranet Amerigroup Ipa $8,242 145%
Triwest Healthcare Alliance $8,242 145%
Texas Independent Health Plan $8,325 147%
Van Lang Ipa $8,325 147%
Wellcare $8,325 147%
Devoted Health $8,407 148%
Provider Partners Health Plan Of Texas $8,407 148%
Superior Health Plan $8,654 152%
Shared Health $8,819 155%
Molina $8,984 158%
Verda Health Plan $9,066 160%
Healthcare Highways $9,485 167%
Curative Administrators $10,640 187%
Molina Healthcare $11,243 198%
Community Health Choice $11,951 211%
Superior $12,775 225%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 605 Holderrieth, Tomball, TX 77375
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals