CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Massac Memorial Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $5,567
Cash Discount Price: $4,190
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Massac Memorial Hospital is $5,567. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,190. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 0.98x the Medicare baseline. Located in 28 Chick Street, Po Box 850, Metropolis, IL.

Cash / Self-Pay

$4,190

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,567

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: $4,190 (74%)

Insurance Median: $5,567 (98%)

Cash: $4,190 (74% of Medicare)

Ins. Median: $5,567 (98% 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
Blue Cross Blue Shield	$2,993 - $19,755	53%
Health Alliance Exchange	$3,400	60%
Health Alliance-All Other Plans	$3,600	63%
Prime Health Services-All Plans	$4,190	74%
Healthlink Hmo	$4,388	77%
Healthlink Ppo-All Other Plans	$4,921	87%
Cigna	$4,933	87%
UnitedHealthcare	$5,028	89%
Multiplan-All Plans	$5,388	95%
Aetna	$6,180 - $19,755	109%
Health Alliance Mcare Adv	$19,755	348%
Humana	$19,755	348%
Molina Ky Mcaid	$19,755	348%

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 $4,190.
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 Massac Memorial 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.