CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Sentara Careplex Hospital

Billing Code: 392 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$13,318

about 2.3× the $5,676 Medicare rate · typically $6,534–$15,831

modeled estimate · not a bill or quote

What this hospital charges insurers

$15,938

Above the fair price

about $2,620 over the fair price · 2.8× Medicare

Medicare pays $5,676 Fair price $13,318 This hospital $15,938

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 $15,938

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 $13,318 (about 2.3× the $5,676 Medicare rate). Sentara Careplex Hospital charges insurers about $15,938 — above the fair price. Located in Hampton, VA.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $13,318. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Humana AetnaCignaKaiser 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	$7,464 - $19,711	132%
Blue Cross Blue Shieldmajor	$7,447 - $16,466	131%
Humanamajor	$7,322	129%
Sentara	$7,251 - $18,682	128%

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, 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 Sentara Careplex 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 Sentara Careplex 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.