CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Banner Boswell Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $6,391
Cash Discount Price: $8,200
vs. Medicare Baseline: 1.13x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Banner Boswell Medical Center is $6,391. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,200. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.13x the Medicare baseline. Located in 13632 N 99Th Ave, Sun City, AZ.

Cash / Self-Pay

$8,200

Average discount available for prompt cash payment at this facility.

Insurance Median

$6,391

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: $8,200 (144%)

Insurance Median: $6,391 (113%)

Cash: $8,200 (144% of Medicare)

Ins. Median: $6,391 (113% 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	$6,086 - $19,774	107%
Arizona Physicians Ipa	$6,086	107%
Banner Health	$6,086	107%
Banner University Health Plan	$6,086	107%
Blue Cross Blue Shield	$6,086 - $16,667	107%
Care 1St	$6,086	107%
Cigna	$6,086 - $23,616	107%
Gila River Health Care Corporation	$6,086	107%
Health Choice Arizona, Inc.	$6,086 - $9,130	107%
Health Net	$6,086 - $9,008	107%
Humana	$6,086 - $6,269	107%
Kaiser Foundation Health Plan	$6,086	107%
Mercy Care	$6,086	107%
Triwest Healthcare Alliance Corp - Va Ccn	$6,086	107%
UnitedHealthcare	$6,086 - $20,692	107%
Upmc Health Plan	$6,086	107%
Wellpoint	$6,086	107%
Carelon	$6,391	113%
Devoted Health Services	$6,391	113%
Arizona Priority Care	$6,695	118%
Gold Kidney Health Plan	$6,695	118%
Oscar Health Plan	$10,043	177%

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 $8,200.
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 Boswell 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.