CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Monroe Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $8,365
Cash Discount Price: $6,312
vs. Medicare Baseline: 1.47x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Monroe Hospital is $8,365. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,312. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.47x the Medicare baseline. Located in 4011 S Monroe Medical Park Blvd, Bloomington, IN.

Cash / Self-Pay

$6,312

Average discount available for prompt cash payment at this facility.

Insurance Median

$8,365

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: $6,312 (111%)

Insurance Median: $8,365 (147%)

Cash: $6,312 (111% of Medicare)

Ins. Median: $8,365 (147% 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
Tricare	$6,260	110%
Aetna	$6,313	111%
Blue Cross Blue Shield	$6,313 - $11,363	111%
Care Source	$6,313 - $9,154	111%
Medicare (plans)	$6,313	111%
UnitedHealthcare	$6,313 - $10,881	111%
Usa Senior Care Network	$6,313	111%
Worthington Christian Fellowship	$6,313	111%
Monroe Medical Group And Managed Health Services	$6,439 - $8,522	113%
Southeastern Indiana Health Operations	$6,473 - $6,904	114%
Provider Partners Health Plan	$6,944	122%
Employer Direct Healthcare	$8,207	145%
Independent Medical Solutions (Ims) Commercial	$10,101	178%
Corvel Workers Compensation	$10,984	194%
Zelis Healthcare Fka Stratose	$11,995	211%
Americas Choice Provider Network Acpn	$12,247	216%
Multiplan	$12,247	216%
Prime Health Services	$12,247	216%
Three Rivers	$12,247	216%
Encore Health Network Workers Compensation	$12,373	218%
Provider Select	$12,500	220%
Provider Network Of America	$12,626	222%
Workers Compensation	$12,626	222%

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 $6,312.
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 Monroe 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.