CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Southern Hills Hospital and Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $7,675
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.35x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Southern Hills Hospital and Medical Center is $7,675. 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 1.35x the Medicare baseline. Located in 9300 West Sunset Rd, Las Vegas, NV.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,675

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: $7,675 (135%)

Ins. Median: $7,675 (135% 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.

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
Imperial Nv	$945 - $9,622	17%
Molina Healthcare	$1,550	27%
Humana	$2,368 - $9,164	42%
Sierra	$3,012 - $3,359	53%
Multiplan	$3,186	56%
First Health	$3,456	61%
Hometown Health Providers	$3,784 - $4,612	67%
Select Health	$3,864 - $11,364	68%
Health Services Coalition	$3,896 - $4,110	69%
Prominence Healthfirst	$4,095	72%
Cigna	$4,327	76%
Aetna	$4,484 - $9,164	79%
Blue Cross Blue Shield	$4,514 - $19,359	80%
United	$5,332 - $8,788	94%
Unified Care Hospice	$7,561 - $7,790	133%
Procare Hospice	$7,561 - $7,790	133%
Hometown Health McR	$8,629 - $8,889	152%
Ambetter / Centene	$8,896 - $16,496	157%
Triwest	$8,896 - $9,164	157%
Alignment Health Plan	$8,896 - $9,164	157%
Caremore	$9,074 - $9,347	160%
Universal Healthcare	$9,518 - $9,806	168%

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 Southern Hills Hospital and 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.