CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Franciscan Health Michigan City

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $11,079
Cash Discount Price: $6,075
vs. Medicare Baseline: 1.95x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Franciscan Health Michigan City is $11,079. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,075. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.95x the Medicare baseline. Located in 3500 Franciscan Way, Michigan City, IN.

Cash / Self-Pay

$6,075

Average discount available for prompt cash payment at this facility.

Insurance Median

$11,079

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: $6,075 (107%)

Insurance Median: $11,079 (195%)

Cash: $6,075 (107% of Medicare)

Ins. Median: $11,079 (195% 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
Medicare (plans)	$6,935	122%
Commercial [2001]	$9,513 - $19,490	168%
Managed Care [2000]	$9,513 - $19,490	168%
United Medical Resources [1158]	$9,513	168%
United Medical Resources [1301]	$9,513 - $10,464	168%
UnitedHealthcare	$9,513 - $10,464	168%
Blue Cross Blue Shield	$11,694 - $13,100	206%
Unicare [1150]	$13,100	231%
Workers Comp [1172]	$13,869	244%
Aetna	$19,490	343%

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 $6,075.
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 Franciscan Health Michigan City 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.