Digestive disorders treatment (inpatient stay)
Facility: Saint Luke'S South Hospital
Billing Code: 392 (MS-DRG)
- CPT Billing Code: 392
- Insurance Median: $10,340
- Cash Discount Price: $30,110
- vs. Medicare Baseline: 1.82x 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 |
|---|---|---|
| Cigna | $1,877 - $18,143 | 33% |
| Humana | $2,900 - $10,340 | 51% |
| Medicaid / KanCare | $4,259 - $4,685 | 75% |
| Transplants-Case Rates [5750] | $4,300 - $83,173 | 76% |
| Blue Cross Blue Shield | $4,870 - $24,285 | 86% |
| Medicare (plans) | $5,233 - $5,495 | 92% |
| Commercial-Contracted [8000] | $5,418 - $8,373 | 95% |
| UnitedHealthcare | $7,678 - $12,644 | 135% |
| Aetna | $12,194 - $24,185 | 215% |
Consumer Guidance & Cost Commentary
For the procedure "Digestive disorders treatment (inpatient stay)" at Saint Luke's South Hospital in Overland Park, KS, the cash median price is $30,110, while the median negotiated rate across payers is $10,340. This facility is a voluntary non-profit acute care hospital located at 12300 Metcalf Avenue. Patients should note that while insurance plans like Cigna, Humana, and UnitedHealthcare have negotiated rates ranging from roughly $1,877 to $12,644 depending on the specific plan, the cash price of $30,110 is significantly higher than the average negotiated amount. However, for individuals with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price directly may result in lower total costs compared to the insurance negotiated rate, which includes administrative overhead and potential deductibles. It is always advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these can further reduce the final amount owed.
The facility's pricing is benchmarked against Medicare, which sets a fixed reimbursement rate of $5,675.87 for this service. The cash median of $30,110 represents a markup of 1.8 times the Medicare amount, illustrating the typical variation between federal cost baselines and commercial pricing. While the data does not provide specific state or county average comparisons for this exact DRG, the wide range of negotiated rates among payers—such as Medicaid/KanCare at $4,259 to $4,685 versus Transplants-Case Rates reaching up