CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Methodist Celina Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $5,964
Cash Discount Price: $16,406
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Methodist Celina Medical Center is $5,964. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16,406. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.05x the Medicare baseline. Located in 1500 S Dallas Parkway, Celina, TX.

Cash / Self-Pay

$16,406

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,964

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: $16,406 (289%)

Insurance Median: $5,964 (105%)

Cash: $16,406 (289% of Medicare)

Ins. Median: $5,964 (105% 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
Aetna	$5,574 - $9,030	98%
Blue Cross Blue Shield	$5,574 - $10,681	98%
Mcs Advantage, Inc Classicare [7021]	$5,574	98%
Medicare (plans)	$5,574 - $5,964	98%
UnitedHealthcare	$5,574 - $5,908	98%
Ust Health Proof [1005]	$5,574	98%
Wellcare [7016]	$5,574	98%
American Health Advantage Of Texas [7099]	$5,853	103%
Cigna	$5,853 - $8,973	103%
Champva [1000]	$5,896	104%
Tricare	$5,896	104%
Triwest Wps [8010]	$5,896	104%
Veterans Administration [9001]	$5,896	104%
Humana	$5,908	104%
Southwestern Health Resources Swhr [7015]	$5,908	104%
Oscar Insurance Company [2057]	$7,804	137%
Department Of Labor [8004]	$7,971	140%
Generic Workers Comp Tx Non Par [9010]	$7,971	140%
Generic Workers Comp Tx Par [8002]	$7,971	140%
Generic Workers Comp Tx Par [9011]	$7,971	140%
Molina [3017]	$8,082	142%
Sana Benefits [3069]	$8,361	147%
Wellpoint Marketplace Exchange [3071]	$8,640	152%
Web Tpa [3049]	$8,973	158%
90 Degree Benefit [3057]	$9,197	162%
Allied National [2031]	$9,197	162%
Entrust/90 Degree [2058]	$9,197	162%
Kempton Group Administrators, Tower Extrusions [3061]	$9,355	165%
Imperial Insurance Companies [3073]	$10,033	177%
Evry Health [1013]	$13,935	246%
Medical Cost Containment Professionals [3059]	$13,935	246%
Velocity [3070]	$13,935	246%

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 $16,406.
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 Methodist Celina 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.