CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Swedish Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $15,743
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.77x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Swedish Medical Center is $15,743. 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 2.77x the Medicare baseline. Located in 747 Broadway, Seattle, WA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$15,743

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: $15,743 (277%)

Ins. Median: $15,743 (277% 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 277% of the Medicare baseline (a markup of 177%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Humana	$8,626 - $9,144	152%
Kaiser	$8,626 - $12,939	152%
Molina	$8,626 - $9,316	152%
Aetna	$8,885 - $28,351	157%
Blue Cross Blue Shield	$8,971 - $21,772	158%
Providence Health Plan	$8,971 - $13,784	158%
UnitedHealthcare	$9,057 - $24,536	160%
Blue Shield	$9,316 - $18,115	164%
Amerigroup	$9,489	167%
Community Health Plan Of Washington	$9,489	167%
Cigna	$10,351 - $22,143	182%
Community Health Plan	$13,802	243%
Coordinated Care	$13,802 - $15,958	243%
Blue Shield-Ballard	$16,577 - $26,920	292%
Blue Shield-First Hill	$16,577 - $26,920	292%
Blue Shield-Mill Creek	$16,577 - $26,920	292%
Blue Shield-Redmond	$16,577 - $26,920	292%
First Choice	$22,246 - $23,474	392%

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 Swedish Medical Center 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.