CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Womans Hospital of Texas,The

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $26,917
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 4.74x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Womans Hospital of Texas,The is $26,917. 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 4.74x the Medicare baseline. Located in 7600 Fannin, Houston, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$26,917

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: $26,917 (474%)
Ins. Median: $26,917 (474% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 474% of the Medicare baseline (a markup of 374%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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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 - $28,840 18%
American Health Plan $1,275 - $28,840 22%
Coventry National First Health $1,941 - $2,855 34%
Oscar $2,131 - $26,917 38%
Aetna $2,415 - $4,837 43%
United $2,865 - $27,219 50%
Evry Health $3,241 - $16,207 57%
Averde Health $7,016 124%
Blue Cross Blue Shield $7,179 - $27,509 126%
Imagine Health $7,734 136%
Kelsey Care (Boon-Chapman) $8,247 145%
Healthcare Highways $9,485 167%
Curative Administrators $10,640 187%
Humana $11,437 - $26,615 202%
Cigna $11,747 - $27,467 207%
Molina Healthcare $13,057 230%
Wellmed $27,234 480%
Amerigroup $27,467 484%
Integranet Amerigroup Ipa $27,467 484%
Texas Healthcare Foundation $27,467 484%
Texas Independent Health Plan $27,467 484%
Triwest Healthcare Alliance $27,467 484%
Wellcare $27,467 484%
Van Lang Ipa $27,741 489%
Devoted Health $28,016 494%
Provider Partners Health Plan Of Texas $28,016 494%
Kelsey Seybold $28,291 498%
Superior Health Plan $28,840 508%
Shared Health $29,389 518%
Universal Healthcare Group $29,664 523%
Molina $29,939 527%
Verda Health Plan $30,213 532%
Fidelis Securecare Of Tx $31,587 557%
Corvel Corporation $38,884 685%
Community Health Choice $39,826 702%
Omni Healthcare $41,241 727%
Superior $42,573 750%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7600 Fannin, Houston, TX 77054
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals