CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Baylor Scott and White Medical Center Lake Pointe

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $7,177
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Baylor Scott and White Medical Center Lake Pointe is $7,177. 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 1.26x the Medicare baseline. Located in 6800 Scenic Dr, Rowlett, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$7,177

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: $7,177 (126%)
Ins. Median: $7,177 (126% 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
Humana $2,778 - $6,835 49%
Healthsmart $2,804 - $10,640 49%
Baylor Scott & White Health Plan $5,829 - $12,303 103%
University Of Mary Hardin-Baylor $6,714 118%
Triwest $6,835 120%
Blue Cross Blue Shield $7,027 - $11,389 124%
Wellpoint (Fka Amerigroup) $7,040 124%
Corvel $7,160 126%
Prime Health Services $7,160 126%
American Health Plan $7,177 126%
Healthspring $7,177 126%
Molina $7,177 126%
Procare Advantage $7,177 126%
Superior Health Plan $7,177 126%
Cigna $7,794 - $9,169 137%
UnitedHealthcare $7,860 - $17,791 138%
Employers Health Network $7,997 141%
Aetna $10,880 192%
Ambetter / Centene $15,447 272%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6800 Scenic Dr, Rowlett, TX 75088
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals