CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: HCA Healthone Presbyterian St Luke's

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $7,427
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.31x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at HCA Healthone Presbyterian St Luke's is $7,427. 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 1.31x the Medicare baseline. Located in 1719 E 19Th Ave, Denver, CO.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,427

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: $7,427 (131%)

Ins. Median: $7,427 (131% 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
Colorado Program For Children With Special Needs	$596	11%
Seasons Hospice	$800	14%
Western Plains Community Health	$950	17%
Physician Health Partners	$1,680 - $1,975	30%
Cigna	$1,810 - $10,256	32%
Kaiser	$3,000 - $7,575	53%
United	$3,401 - $10,630	60%
Rocky Mountain Health Plan	$4,946 - $10,630	87%
Aetna	$5,738 - $23,483	101%
UnitedHealthcare	$6,313	111%
Blue Cross Blue Shield	$7,427 - $20,693	131%
Bright Health	$7,427	131%
Humana	$7,427	131%
Kaiser National Transplant	$7,427	131%
Rocky Mountain Health	$7,427	131%
Total Longterm Care	$7,427	131%
Triwest Health Alliance	$7,427	131%
Devoted Health	$7,575	133%
Innovage Pace	$7,575	133%
Delaware Life Insurance	$7,650	135%
Wellcare	$7,650	135%
Mutual Of Omaha	$7,798	137%
Pinnacol Workers Comp	$9,335	164%
Multiplan	$9,728	171%

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 HCA Healthone Presbyterian St Luke's 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.