CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Ascension Seton Northwest

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $4,946
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.87x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Ascension Seton Northwest is $4,946. 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 0.87x the Medicare baseline. Located in 11113 Research Boulevard, Austin, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,946

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: $4,946 (87%)
Ins. Median: $4,946 (87% 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
Tricare $4,279 - $4,658 75%
Aarp Mc Wellmed $4,847 85%
Sendero Chap $4,896 86%
Addr Cancer Together $4,946 87%
Aetna $4,946 87%
Covid Hrsa $4,946 87%
Devoted Health Mcr Replacement $4,946 87%
Humana $4,946 87%
Medicare (plans) $4,946 87%
Research Study $4,946 87%
Smarthealth $4,946 87%
Superior Allwell $4,946 87%
Wellcare Med Advantage $4,946 87%
UnitedHealthcare $5,045 89%
Connected Senior Care $5,094 90%
Pphp Mcr Advantage $5,193 91%
Tx Independence Hp $5,193 91%
Cshcn Cidc $6,150 108%
Occunet $6,924 122%
Sendero Idealcare $8,655 152%
Ambetter / Centene $8,903 157%
Whole Foods $9,063 160%
Oscar Health Exchange $9,379 165%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 11113 Research Boulevard, Austin, TX 78759
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals