CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Harlingen Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $7,039
Cash Discount Price: $7,039
vs. Medicare Baseline: 1.24x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Harlingen Medical Center is $7,039. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,039. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.24x the Medicare baseline. Located in 5501 South Expressway 77, Harlingen, TX.

Cash / Self-Pay

$7,039

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,039

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%)

Cash / Self-Pay: $7,039 (124%)

Insurance Median: $7,039 (124%)

Cash: $7,039 (124% of Medicare)

Ins. Median: $7,039 (124% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Tricare	$5,526	97%
Humana	$6,336 - $7,039	112%
Aetna	$6,929 - $7,959	122%
Blue Cross Blue Shield	$7,039	124%
Careworks Worker Compensation Fka Rockport Community Network	$7,039	124%
Cigna	$7,039 - $7,251	124%
Corporate Remedies Worker Compensation	$7,039	124%
Medicare (plans)	$7,039	124%
San Benito Medical Associates	$7,039	124%
Superior Health Plan	$7,039	124%
Texas Bluebonnett Health Plan	$7,039 - $11,615	124%
UnitedHealthcare	$7,039	124%
Wellmed	$7,039	124%
Workers Compensation	$7,039	124%
Molina	$7,391 - $10,911	130%
Provider Partners Health Plan	$7,391	130%
Imperial Insurance Company	$7,462	131%
Asserta Health	$9,151	161%
Employer Direct Healthcare	$9,151	161%
Friday Health Plan	$9,151	161%
Magic Valley Electric Cooperative	$9,151	161%
Superior Health Commercial Exchange	$9,151	161%
Naphcare	$10,911	192%
Keenan	$11,250	198%
Baker Benefits Administrators	$12,319	217%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $7,039.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 392.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Harlingen Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 392.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.