CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: John Randolph Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $6,646
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at John Randolph Medical Center is $6,646. 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 1.17x the Medicare baseline. Located in 411 West Randolph Road, Hopewell, VA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,646

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: $6,646 (117%)
Ins. Median: $6,646 (117% 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.

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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
Align Senior Care $1,275 - $6,614 22%
United $4,267 - $8,386 75%
Humana $6,422 113%
Sentara Health $6,422 113%
United Behavioral Health $6,422 113%
Cigna $6,550 - $20,824 115%
Devoted $6,550 115%
Virginia Premier Health $6,550 115%
Aetna $6,559 - $29,411 116%
Blue Cross Blue Shield $6,614 - $18,079 117%
Clear Spring Health Plan $6,614 117%
Naphcare $6,614 117%
Davita Village Health $6,678 118%
Lifeworks $6,743 119%
Pyramid Life $7,064 124%
Universal Healthcare Group $7,064 124%
Oscar $9,011 159%
Optima Health $20,738 365%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 411 West Randolph Road, Hopewell, VA 23860
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals