CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Presence St Marys Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $7,036
  • Cash Discount Price: $6,830
  • vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Presence St Marys Hospital is $7,036. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,830. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.24x the Medicare baseline. Located in 500 W Court St, Kankakee, IL.
Cash / Self-Pay
$6,830

Average discount available for prompt cash payment at this facility.

Insurance Median
$7,036

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: $6,830 (120%)
Insurance Median: $7,036 (124%)
Cash: $6,830 (120% of Medicare)
Ins. Median: $7,036 (124% 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
Tricare $6,263 110%
Blue Cross Blue Shield $6,489 - $10,430 114%
Cigna $6,709 - $6,831 118%
Aetna $6,831 - $7,172 120%
Celtic (Wellcare) $6,831 120%
Devoted Health $6,831 120%
Humana $6,831 - $7,514 120%
Longevity Health Plan Of Illinois $6,831 120%
Medicare (plans) $6,831 120%
Self-Pay $6,831 120%
United Behavioral Health $6,831 120%
UnitedHealthcare $6,831 120%
Village Md Chicago $6,831 120%
Clear Spring Health Of Illinois $6,899 122%
Molina $7,036 - $10,246 124%
Zing Health Provider Network $7,036 124%
Meridian $7,172 126%
Provider Partners Health Plan (Pphp) $7,172 126%
Access Community Health Network $8,197 144%
Clifton Health System $10,588 187%
Ambetter / Centene $11,066 195%
Coventry $11,499 203%
Healthlink, Inc. $11,499 203%
Workers Comp $12,105 213%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 500 W Court St, Kankakee, IL 60901
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals