CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Swedish Issaquah

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $11,758
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.07x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Swedish Issaquah is $11,758. 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 2.07x the Medicare baseline. Located in 751 Ne Blakely Dr, Issaquah, WA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$11,758

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: $11,758 (207%)
Ins. Median: $11,758 (207% 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 207% of the Medicare baseline (a markup of 107%). 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.

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
Kaiser $7,348 - $11,023 129%
Molina $7,348 - $7,936 129%
Aetna $7,569 - $7,642 133%
Blue Cross Blue Shield $7,642 - $16,480 135%
Providence Health Plan $7,642 - $14,550 135%
UnitedHealthcare $7,716 - $24,536 136%
Humana $7,789 137%
Blue Shield $7,936 - $16,577 140%
Amerigroup $8,083 142%
Community Health Plan Of Washington $8,083 142%
Cigna $8,818 - $22,143 155%
Community Health Plan $11,758 207%
Coordinated Care $11,758 - $13,595 207%
First Choice $19,659 - $20,059 346%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 751 Ne Blakely Dr, Issaquah, WA 98029
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals