CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Carilion Franklin Memorial Hospital

Billing Code: 392 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$7,158

about 1.3× the $5,676 Medicare rate · typically $6,095–$10,227

modeled estimate · not a bill or quote

What this hospital charges insurers

$7,247

About the fair price

about $89 over the fair price · 1.3× Medicare

Medicare pays $5,676 Fair price $7,158 This hospital $7,247 Cash price $8,130 Hospital's list price $23,228

How we calculate the fair BaseRate →

How this hospital compares to other VA hospitals

Highest price of the 9 VA hospitals we have prices for — worth calling around.

Cheapest $3,942 Priciest $7,247

Black dot = this hospital, among the 9 VA hospitals with a price for this procedure. Full list below.

A fair price for a Digestive disorders treatment (inpatient stay) is about $7,158 (about 1.3× the $5,676 Medicare rate). Carilion Franklin Memorial Hospital charges insurers about $7,247, or about $8,130 in cash — about the fair price. Located in Rocky Mount, VA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$7,247 - $18,987	128%
Blue Cross Blue Shieldmajor	$7,177 - $21,080	126%
Aetnamajor	$6,614 - $15,424	117%
Cignamajor	$15,656 - $16,724	276%
Humanamajor	$6,896 - $23,451	121%
Sentara	$7,388 - $14,402	130%
+ 8 smaller / regional plans	$14,402 - $22,067

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 8,130), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 392.

Insurance Before you use insurance

Call your insurance company to confirm Carilion Franklin Memorial Hospital is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 392.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Carilion Franklin Memorial Hospital

Compare: Digestive disorders treatment (inpatient stay) at other VA hospitals

Childrens Hospital of the Kings Daughters Inc · Norfolk $3,942
Sentara Rmh Medical Center · Harrisonburg $5,843
Buchanan General Hospital · Grundy $5,970
Sovah Health Danville · Danville $6,010
Clinch Valley Medical Center · Richlands $6,061
Lewisgale Hospital Alleghany · Low Moor $6,168
Wythe County Community Hospital · Wytheville $6,255
Twin County Regional Hospital · Galax $6,451

Insurance negotiated median for the same procedure, sorted lowest first.