Digestive disorders treatment (inpatient stay)
Facility: Providence Medical Center
Billing Code: 392 (MS-DRG)
- CPT Billing Code: 392
- Insurance Median: $6,863
- Cash Discount Price: $6,862
- vs. Medicare Baseline: 1.21x 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 | $4,253 - $9,608 | 75% |
| Medicaid / KanCare | $4,253 | 75% |
| Healthy Blue | $4,338 - $7,206 | 76% |
| Celtic | $4,338 - $9,265 | 76% |
| Aetna | $4,338 - $9,554 | 76% |
| Tricare | $5,543 - $6,863 | 98% |
| Blue Cross Blue Shield | $5,730 - $9,139 | 101% |
| Oha Networks | $5,806 | 102% |
| Worker Compensation | $5,986 | 105% |
| Midland Care Connection | $6,863 | 121% |
| Cigna | $6,863 | 121% |
| Medicare (plans) | $6,863 | 121% |
| Kansas Superior Select | $7,206 | 127% |
| Employer Direct Healthcare | $8,922 | 157% |
| Corizon | $8,922 | 157% |
| Well Path Prison | $9,608 | 169% |
| Centurion | $10,294 | 181% |
| Naphcare | $10,638 | 187% |
| Keenan | $11,250 | 198% |
Consumer Guidance & Cost Commentary
For the procedure code 392, "Digestive disorders treatment (inpatient stay)," at Providence Medical Center in Kansas City, KS, the cash median price is $6,862.00, while the median negotiated rate across payers is $6,863.00. This indicates that paying cash directly may be slightly more cost-effective than using insurance for this specific service, as the negotiated rates are nearly identical to the cash price. Unlike many facilities where insurance contracts inflate costs significantly above cash rates, the administrative overhead and contract dynamics here result in a negligible difference, meaning patients with high-deductible plans might save money by paying out-of-pocket if they can secure the cash rate before services are rendered.
The facility's pricing is benchmarked against Medicare, which sets a baseline rate of $5,675.87 for this code. The commercial negotiated rates are approximately 120% of the Medicare amount, aligning with the range of fair pricing typically defined between 120% and 150% of the federal standard. While the facility is a voluntary non-profit church-owned acute care hospital with a 3-star rating, patients should be aware that some payers, such as Medicaid/KanCare and certain employer plans, have fixed rates as low as $4,253, which is significantly lower than the cash and Medicare benchmarks. To ensure the lowest possible cost, patients are encouraged to request a self-pay or prompt-pay discount prior to scheduling, as these upfront payment incentives can bypass the standard insurance billing cycle and reduce administrative fees.