Digestive disorders treatment (inpatient stay)
Facility: Saint John Hospital
Billing Code: 392 (MS-DRG)
- CPT Billing Code: 392
- Insurance Median: $5,378
- Cash Discount Price: $5,195
- vs. Medicare Baseline: 0.95x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
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 | $3,481 - $6,962 | 61% |
| UnitedHealthcare | $3,904 - $7,274 | 69% |
| Medicaid / KanCare | $3,904 | 69% |
| Celtic | $3,982 - $7,014 | 70% |
| Healthy Blue | $3,982 - $5,456 | 70% |
| Medicare (plans) | $5,196 | 92% |
| Tricare | $5,196 - $5,489 | 92% |
| Aetna | $5,196 - $8,039 | 92% |
| Cigna | $5,196 | 92% |
| Midland Care Connection | $5,196 | 92% |
| Kansas Superior Select | $5,300 | 93% |
| Oha Networks | $5,806 | 102% |
| Worker Compensation | $5,986 | 105% |
| Employer Direct Healthcare | $6,755 | 119% |
| Corizon | $7,274 | 128% |
| Well Path | $7,274 | 128% |
| Centurion | $7,794 | 137% |
| Naphcare | $8,053 | 142% |
Consumer Guidance & Cost Commentary
For the procedure "Digestive disorders treatment (inpatient stay)" at Saint John Hospital in Leavenworth, KS, the cash median price is $5,195.00, which is lower than the Medicare benchmark of $5,675.87. While commercial insurance plans like Blue Cross Blue Shield and UnitedHealthcare have negotiated rates ranging from approximately $3,481 to $7,274, these figures often exceed the cash price. Patients with high-deductible plans may find paying the cash median of $5,195.00 directly more cost-effective than relying on insurance, as the negotiated rates for many payers are higher than the self-pay amount. It is important to note that while the facility offers a cash rate, patients should verify if their specific insurance plan has a lower allowed amount before scheduling, as some commercial contracts may result in lower out-of-pocket costs than the cash price.
The facility's negotiated rates vary significantly across different payers, with the lowest range starting at $3,481 for Blue Cross Blue Shield and the highest reaching $8,053 for Naphcare. These commercial rates are generally higher than the Medicare benchmark, which serves as a reliable baseline for fair pricing. To minimize costs, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront. Additionally, if a patient receives a bill from an out-of-network provider or encounters unexpected charges, they should request an itemized billing audit to identify errors or unbundled codes, as over 80% of hospital bills contain mistakes