Digestive disorders treatment (inpatient stay)
Facility: Kansas Spine & Specialty Hospital, Llc
Billing Code: 392 (MS-DRG)
- CPT Billing Code: 392
- Insurance Median: $5,093
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.90x 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 | $1,401 - $5,093 | 25% |
| Blue Cross Blue Shield | $2,613 - $5,093 | 46% |
| Humana | $4,991 | 88% |
| United Mine Workers Of America | $5,093 | 90% |
| Providrs Care Network | $5,093 - $6,712 | 90% |
| Aetna | $5,093 - $6,773 | 90% |
| Lantern Specialty Care | $8,148 | 144% |
Consumer Guidance & Cost Commentary
For the procedure "Digestive disorders treatment (inpatient stay)" at Kansas Spine & Specialty Hospital, Llc in Wichita, KS, the facility's negotiated rate of $5,093 is significantly lower than the highest commercial rates observed, such as the $8,148 charged by Lantern Specialty Care. While the facility's negotiated rate aligns with the lowest end of the commercial spectrum, it is important to note that cash payments are not explicitly listed in the available data. However, for patients with high-deductible plans, paying cash upfront can sometimes be more cost-effective if the insurance negotiated rate exceeds the cash price, making it essential to inquire directly with the hospital about "self-pay" or "prompt-pay" discounts before scheduling.
This service is categorized under the MS-DRG for inpatient digestive disorder treatment, and the facility's pricing structure is benchmarked against the federal Medicare rate of $5,675.87. The facility's negotiated rate of $5,093 represents a 0.9x ratio compared to the Medicare amount, indicating a rate that is slightly below the federal baseline. Since Medicare rates serve as the objective cost baseline for healthcare delivery, this comparison reveals that the facility's contracted rates are competitive relative to the true cost of care. Patients should be aware that commercial rates often include administrative overheads that can inflate costs, and verifying the specific allowed amount with their insurance provider is crucial to understanding their final out-of-pocket responsibility.