Digestive disorders treatment (inpatient stay)
Facility: Kansas City Orthopaedic Institute
Billing Code: 392 (MS-DRG)
- CPT Billing Code: 392
- Insurance Median: $5,827
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.03x 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 |
|---|---|---|
| Aetna | $5,224 | 92% |
| Cigna | $5,224 - $6,793 | 92% |
| UnitedHealthcare | $5,224 - $7,450 | 92% |
| Blue Cross Blue Shield | $5,276 - $8,919 | 93% |
| Medica | $7,829 | 138% |
Consumer Guidance & Cost Commentary
For the procedure code 392, "Digestive disorders treatment (inpatient stay)," at Kansas City Orthopaedic Institute in Leawood, KS, the negotiated rates vary significantly by insurer, ranging from a low of $5,224 with Aetna to a high of $8,919 with Blue Cross Blue Shield. While the facility's median negotiated rate is $5,827, the Medicare benchmark for this service is $5,675.87, indicating that the facility's average commercial rate is slightly above the federal baseline. It is important to note that cash-pay options are not listed for this specific code, meaning patients without insurance coverage may not be able to access the potential savings of a cash discount. Additionally, because this is an in-network facility, the No Surprises Act generally protects patients from balance billing for out-of-network emergency services or ancillary providers, though patients should still verify that all specific services rendered were covered under their plan.
Patients should be aware that commercial negotiated rates often include administrative overhead and do not always represent the lowest possible price, especially for those with high-deductible plans. Although the facility is owned by a physician group, there is no cash median or negotiated rate provided in the data, so patients cannot currently compare a self-pay price against the state or county average to determine potential savings. To minimize costs, individuals should contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% if paid in full upfront. Furthermore, if a bill is received, consumers should request a detailed itemized audit to ensure no errors, unbundled codes, or