CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Mt Sinai Hospital Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $8,385
  • Cash Discount Price: $16,527
  • vs. Medicare Baseline: 1.48x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Mt Sinai Hospital Medical Center is $8,385. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16,527. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.48x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.
Cash / Self-Pay
$16,527

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,385

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: $16,527 (291%)
Insurance Median: $8,385 (148%)
Cash: $16,527 (291% of Medicare)
Ins. Median: $8,385 (148% 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.

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
Hfn Platinum $5,340 94%
Hfn Epo $6,245 110%
Blue Cross Blue Shield $6,803 - $9,058 120%
Lawndale Christian - All Plans $6,996 123%
Cigna $7,746 - $16,034 136%
Tricare $7,746 136%
Va Healthnet - All Plans $7,746 136%
Advocate Physician Prtnrs Mcr $7,985 141%
Cenpatico Illinicare Dual $7,985 141%
Cenpatico Illinicare Mcr - All Other Plans $7,985 141%
Harmony Behavioral Htlh - All Plans $7,985 141%
Humana $7,985 - $10,288 141%
Meridian/Harmony D-Snp - All Plans $7,985 141%
Molina Mcaid $7,985 141%
Nextlevel Hlth Icp Fhp Aca - All Plans $7,985 141%
Zing Mcr Adv - All Plans $8,305 146%
Ambetter / Centene $8,385 - $8,784 148%
Molina Mcr - All Other Plans $8,385 148%
Advocate Physician Prtnrs - All Other Plans $8,784 155%
Partners In Hlth - All Plans $9,444 166%
Oscar - All Plans $10,319 182%
Aetna $11,506 203%
Evernorth Behav Hlth Comm - All Other Plans $11,805 208%
UnitedHealthcare $13,621 - $57,535 240%
Compsych Ip/Op Only - All Plans $14,166 250%
Multiplan Primary Ntwrk/Phcs - All Other Plans $16,527 291%
Multiplan Complementary Ntwrk $18,888 333%
Hfn Ppo - All Other Plans $20,776 366%
Healthlink Hmo $22,196 391%
Healthlink Ppo - All Other Plans $23,588 416%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15Th Street at California, Chicago, IL 60608
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals