CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Texas Orthopedic Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $5,686
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Texas Orthopedic Hospital is $5,686. 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 1.00x the Medicare baseline. Located in 7401 South Main Street, Houston, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,686

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: $5,686 (100%)
Ins. Median: $5,686 (100% 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
Corvel Corporation $570 - $7,891 10%
Texas Athletic Network $750 13%
Procare Advantage $995 - $5,853 18%
American Health Plan $1,275 - $5,853 22%
Aetna $1,779 - $4,272 31%
Coventry National First Health $1,941 - $2,855 34%
Oscar $2,131 - $8,639 38%
United $3,048 - $7,810 54%
Evry Health $3,241 - $16,207 57%
Humana $5,401 - $11,437 95%
Cigna $5,518 - $14,664 97%
Wellmed $5,518 97%
Amerigroup $5,574 98%
Blue Cross Blue Shield $5,574 - $12,195 98%
Kelsey Seybold $5,574 98%
Texas Healthcare Foundation $5,574 98%
Triwest Healthcare Alliance $5,574 98%
Van Lang Ipa $5,630 99%
Devoted Health $5,686 100%
Integranet Amerigroup Ipa $5,686 100%
Provider Partners Health Plan Of Texas $5,686 100%
Superior Health Plan $5,853 103%
Texas Independent Health Plan $5,908 104%
Wellcare $5,908 104%
Shared Health $5,964 105%
Universal Healthcare Group $6,020 106%
Molina $6,076 107%
Verda Health Plan $6,131 108%
Fidelis Securecare Of Tx $6,243 110%
Averde Health $7,016 124%
Imagine Health $7,734 136%
Community Health Choice $8,082 142%
Omni Healthcare $8,369 147%
Superior $8,640 152%
Healthcare Highways $9,485 167%
Curative Administrators $10,640 187%
Molina Healthcare $11,604 204%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7401 South Main Street, Houston, TX 77030
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals