CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Banner - University Medical Center Phoenix

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $9,123
Cash Discount Price: $12,503
vs. Medicare Baseline: 1.61x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Banner - University Medical Center Phoenix is $9,123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12,503. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.61x the Medicare baseline. Located in 1111 East McDowell Road, Phoenix, AZ.

Cash / Self-Pay

$12,503

Average discount available for prompt cash payment at this facility.

Insurance Median

$9,123

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%)

Cash / Self-Pay: $12,503 (220%)

Insurance Median: $9,123 (161%)

Cash: $12,503 (220% of Medicare)

Ins. Median: $9,123 (161% 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
Aetna	$8,146 - $19,774	144%
Arizona Physicians Ipa	$8,146	144%
Banner Health	$8,146	144%
Banner University Health Plan	$8,146	144%
Blue Cross Blue Shield	$8,146 - $19,520	144%
Care 1St	$8,146	144%
Gila River Health Care Corporation	$8,146	144%
Health Choice Arizona, Inc.	$8,146 - $12,218	144%
Health Net	$8,146 - $12,055	144%
Kaiser Foundation Health Plan	$8,146	144%
Mercy Care	$8,146	144%
Triwest Healthcare Alliance Corp - Va Ccn	$8,146	144%
UnitedHealthcare	$8,146 - $20,692	144%
Upmc Health Plan	$8,146	144%
Wellpoint	$8,146	144%
Humana	$8,390	148%
Carelon	$8,553	151%
Devoted Health Services	$8,553	151%
Arizona Priority Care	$8,960	158%
Gold Kidney Health Plan	$8,960	158%
Naphcare	$13,033	230%
Oscar Health Plan	$13,440	237%
Cigna	$21,255 - $23,616	374%

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 $12,503.
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 Banner - University Medical Center Phoenix 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.