CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Baylor Scott & White Medical Center - Marble Falls

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $8,209
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.45x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Baylor Scott & White Medical Center - Marble Falls is $8,209. 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 1.45x the Medicare baseline. Located in 810 W Highway 71, Marble Falls, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$8,209

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: $8,209 (145%)

Ins. Median: $8,209 (145% 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
Humana	$2,778 - $13,286	49%
Healthsmart	$2,804 - $10,640	49%
Blue Cross Blue Shield	$3,725 - $8,228	66%
Bluebell Creameries	$4,292	76%
University Of Mary Hardin-Baylor	$6,714	118%
Cigna	$7,293 - $8,579	128%
Baylor Scott & White Health Plan	$7,444 - $14,105	131%
Superior Health Plan	$7,836	138%
Triwest	$7,836	138%
Corvel	$8,209	145%
Prime Health Services	$8,209	145%
American Health Plan	$8,228	145%
Healthspring	$8,228	145%
Procare Advantage	$8,228	145%
UnitedHealthcare	$9,012 - $10,768	159%
Sedgwick	$9,733	171%
Aetna	$10,880	192%

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 $X.
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 Baylor Scott & White Medical Center - Marble Falls 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.