Digestive disorders treatment (inpatient stay)
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 392 (MS-DRG)
- CPT Billing Code: 392
- Insurance Median: $6,399
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.13x 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 |
|---|---|---|
| UnitedHealthcare | $3,484 | 61% |
| Medicaid / KanCare | $3,623 - $3,658 | 64% |
| Aetna | $6,399 | 113% |
| Smarthealth | $6,403 | 113% |
| Blue Cross Blue Shield | $7,767 - $8,175 | 137% |
Consumer Guidance & Cost Commentary
For the procedure "Digestive disorders treatment (inpatient stay)" at Ascension Via Christi Hospital Manhattan, Inc, the negotiated rates vary significantly by payer, ranging from $3,484 for UnitedHealthcare to $8,175 for Blue Cross Blue Shield. While commercial insurance contracts often include administrative overhead that inflates the baseline price by 20% to 40%, the median negotiated rate of $6,399 is notably higher than the facility's cash median, which is not reported. For patients with high-deductible plans, paying cash upfront can sometimes be more cost-effective if the insurance negotiated rate exceeds the cash price, though this facility does not currently list a specific cash median. It is important to verify "self-pay" or "prompt-pay" discounts directly with the hospital before scheduling, as these upfront payment incentives can bypass costly insurance billing cycles and administrative fees.
This service is categorized under the MS-DRG for inpatient digestive disorders treatment, with a Medicare benchmark amount of $5,675.87. The facility's negotiated rates generally align with the expected commercial markup, where rates typically average 200% to 300% of the Medicare baseline, though fair pricing is often defined as 120% to 150% of Medicare. Since the specific cash median is unavailable, patients should avoid relying on summary bills that obscure individual charges and instead request a full itemized CPT-coded statement to identify any unbundled codes or services not rendered. If a balance bill arises from out-of-network ancillary services, the No Surprises Act provides federal protections against surprise billing for emergency care and non-emergency services at in-network facilities,