CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Lone Peak Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $8,440
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.49x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Lone Peak Hospital is $8,440. 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 1.49x the Medicare baseline. Located in 11925 South State Street, Draper, UT.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$8,440

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: $8,440 (149%)

Ins. Median: $8,440 (149% 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
Sterling Life Insurance	$1,075 - $5,853	19%
Aetna	$3,564 - $12,130	63%
Bright Health	$5,021	88%
Humana	$5,251 - $11,939	93%
Coventry Altius	$5,361	94%
Cigna	$5,470 - $21,883	96%
Molina Healthcare	$5,470 - $7,390	96%
State Of Utah	$5,470	96%
Triwest Healthcare Alliance	$5,470	96%
University Of Ut	$5,470	96%
Veteran'S Administration	$5,470	96%
Blue Cross Blue Shield	$5,525	97%
Molina	$6,062	107%
Regence	$7,035 - $11,676	124%
Health Choice	$7,353	130%
Hosp Uncompensated Care	$7,353	130%
Elap	$8,078	142%
Angle Insurance	$8,440	149%
University Of Utah	$9,708 - $12,976	171%
Pehp	$12,184 - $15,422	215%
Multiplan	$14,055	248%
Motivhealth	$14,958	264%
Dmba (Deseret Mutual Benefit Admin)	$15,529	274%
Imagine Health Wise	$15,925	281%

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 Lone Peak Hospital 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.