CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Providence Regional Medical Center Everett

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $13,153
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.32x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Providence Regional Medical Center Everett is $13,153. 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 2.32x the Medicare baseline. Located in 1321 Colby Avenue, Everett, WA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$13,153

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: $13,153 (232%)
Ins. Median: $13,153 (232% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 232% of the Medicare baseline (a markup of 132%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Kaiser $7,737 - $11,606 136%
Molina $7,737 - $8,356 136%
Aetna $7,969 - $18,649 140%
Blue Cross Blue Shield $8,047 - $22,572 142%
Providence Health Plan $8,047 - $16,082 142%
UnitedHealthcare $8,124 - $20,477 143%
Blue Shield $8,356 - $19,862 147%
Amerigroup $8,511 150%
Community Health Plan Of Washington $8,511 150%
Humana $8,511 150%
Community Health Plan $12,379 218%
Coordinated Care $12,379 - $14,314 218%
First Choice $18,331 323%
Cigna $23,916 421%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1321 Colby Avenue, Everett, WA 98201
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals