CMS Price Transparency Data
Digestive disorders treatment (inpatient stay)
Facility: Methodist Southlake Medical Center
Billing Code: 392 (MS-DRG)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 392
- Insurance Median: $7,398
- Cash Discount Price: $16,875
- vs. Medicare Baseline: 1.30x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Methodist Southlake Medical Center is $7,398. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16,875. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.30x the Medicare baseline. Located in 421 E State Highway 114, Southlake, TX.
Cash / Self-Pay
$16,875
Average discount available for prompt cash payment at this facility.
Insurance Median
$7,398
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: $16,875 (297%)
Insurance Median: $7,398 (130%)
Cash: $16,875 (297% of Medicare)
Ins. Median: $7,398 (130% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Bind Benefits Inc [1004] | $4,287 | 76% |
| Definity Health [3006] | $4,287 | 76% |
| Freedom Life Insurance Company [2029] | $4,287 | 76% |
| Geha Federal [3066] | $4,287 | 76% |
| Tml Intergovernmental Employee Benefits [3050] | $4,287 | 76% |
| UnitedHealthcare | $4,287 - $5,919 | 76% |
| Aetna | $5,584 - $13,252 | 98% |
| Blue Cross Blue Shield | $5,584 - $14,516 | 98% |
| Medicare (plans) | $5,584 - $5,974 | 98% |
| Ust Health Proof [1005] | $5,584 | 98% |
| Wellcare [7016] | $5,584 | 98% |
| American Health Advantage Of Texas [7099] | $5,863 | 103% |
| Cigna | $5,863 - $8,973 | 103% |
| Globalhealth [1003] | $5,863 | 103% |
| Procare Advantage [7018] | $5,863 | 103% |
| Champva [1000] | $5,896 | 104% |
| Tricare | $5,896 | 104% |
| Triwest Wps [8010] | $5,896 | 104% |
| Veterans Administration [9001] | $5,896 | 104% |
| Humana | $5,919 | 104% |
| Southwestern Health Resources Swhr [7015] | $5,919 | 104% |
| Provider Partners Health Plan [7025] | $6,142 | 108% |
| Mcs Advantage, Inc Classicare [7021] | $6,310 | 111% |
| Medical Card System [2063] | $6,310 | 111% |
| Alternative Service Concepts [8005] | $6,980 | 123% |
| Oscar Insurance Company [2057] | $7,817 | 138% |
| Department Of Labor [8004] | $7,985 | 141% |
| Generic Workers Comp Tx Non Par [9010] | $7,985 | 141% |
| Generic Workers Comp Tx Par [8002] | $7,985 | 141% |
| Generic Workers Comp Tx Par [9011] | $7,985 | 141% |
| Tristar Risk Management [8006] | $7,985 | 141% |
| Bright Healthcare [2222] | $8,071 | 142% |
| Molina [3017] | $8,096 | 143% |
| Sana Benefits [3069] | $8,375 | 148% |
| Wellpoint Marketplace Exchange [3071] | $8,655 | 152% |
| Web Tpa [3049] | $8,973 - $13,252 | 158% |
| 90 Degree Benefit [3057] | $9,213 | 162% |
| Allied National [2031] | $9,213 | 162% |
| Entrust/90 Degree [2058] | $9,213 | 162% |
| Kempton Group Administrators, Tower Extrusions [3061] | $9,355 | 165% |
| Friday Health Plan [2061] | $9,492 | 167% |
| Ambetter / Centene | $9,548 | 168% |
| Imperial Insurance Companies [3073] | $10,051 | 177% |
| Scott & White Health Plan Trs [3062] | $11,362 | 200% |
| Evry Health [1013] | $13,959 | 246% |
| Medical Cost Containment Professionals [3059] | $13,959 | 246% |
| Velocity [3070] | $13,959 | 246% |
| Dart Member Care [3039] | $15,076 | 266% |
| Healthscope Benefits [2052] | $15,076 | 266% |
| Healthscope Benefits [3063] | $15,076 | 266% |