CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Franciscan Health Lafayette

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $19,490
Cash Discount Price: $6,211
vs. Medicare Baseline: 3.43x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Franciscan Health Lafayette is $19,490. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,211. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 3.43x the Medicare baseline. Located in 1701 S Creasy Ln, Lafayette, IN.

Cash / Self-Pay

$6,211

Average discount available for prompt cash payment at this facility.

Insurance Median

$19,490

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: $6,211 (109%)

Insurance Median: $19,490 (343%)

Cash: $6,211 (109% of Medicare)

Ins. Median: $19,490 (343% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 343% of the Medicare baseline (a markup of 243%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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)	$7,275	128%
Blue Cross Blue Shield	$11,694 - $16,740	206%
Workers Comp [1172]	$14,549	256%
Unicare [1150]	$16,740	295%
Commercial [2001]	$19,490 - $24,370	343%
Managed Care [2000]	$19,490 - $24,370	343%
Aetna	$22,745	401%
Cigna	$24,370	429%
Great West Insurance [1055]	$24,370	429%

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 $6,211.
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 Lafayette 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.