CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Hammond Henry Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $3,146
Cash Discount Price: $16,595
vs. Medicare Baseline: 0.55x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Hammond Henry Hospital is $3,146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16,595. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 0.55x the Medicare baseline. Located in 600 N College Avenue, Geneseo, IL.

Cash / Self-Pay

$16,595

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,146

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: $16,595 (292%)

Insurance Median: $3,146 (55%)

Cash: $16,595 (292% of Medicare)

Ins. Median: $3,146 (55% 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
Humana	$600 - $3,146	11%
Multiplan Phcs Pediatric	$600	11%
Healthsmart Adult-All Other Plans	$970	17%
Blue Cross Blue Shield	$1,099 - $1,236	19%
Healthsmart Pediatric	$1,100	19%
Multiplan Phcs Adult	$1,100	19%
Cigna	$1,155	20%
Usa Mco-All Plans	$1,250	22%
Quad City Community Hc-All Plans	$2,000	35%
Tricare	$2,832	50%
UnitedHealthcare	$3,000 - $3,146	53%
Aetna	$3,146 - $13,829	55%
Health Alliance Mcare Adv	$3,146	55%
Springfield Armory-All Plans	$3,900	69%
Ambetter / Centene	$4,912	87%
Wellmark Of Ia-All Plans	$9,220	162%
Health Alliance-All Other Plans	$13,829	244%
Multiplan Integrated Hp	$13,829	244%
Multiplan Pponext	$14,751	260%
Osf Direct Access Network-All Plans	$14,751	260%
Multiplan-All Other Plans	$15,673	276%
Corvel-All Plans	$16,595	292%
Hfn-All Plans	$16,595	292%
Multiplan Beech Street	$16,595	292%

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 $16,595.
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 Hammond Henry Hospital 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.