Digestive disorders treatment (inpatient stay)
Facility: Rooks County Health Center
Billing Code: 392 (MS-DRG)
- CPT Billing Code: 392
- Insurance Median: $9,619
- Cash Discount Price: $7,594
- vs. Medicare Baseline: 1.69x 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 |
|---|---|---|
| Healthy Blue Mcaid - All Plans | $3,495 | 62% |
| Blue Cross Blue Shield | $7,365 | 130% |
| UnitedHealthcare | $9,112 | 161% |
| Preferred Benefits Admin | $9,112 | 161% |
| Aetna | $9,112 | 161% |
| Health Partners - All Plans | $9,619 | 169% |
| Preferred Hlthcare - All Other Plans | $9,619 | 169% |
| Veterans Admin - All Plans | $10,140 | 179% |
| Tricare | $20,265 | 357% |
| Celtic Mcr Adv | $20,265 | 357% |
| Celtic Comm - All Other Plans | $21,279 | 375% |
Consumer Guidance & Cost Commentary
For this inpatient stay at Rooks County Health Center in Plainville, Kansas, the cash price of $7,594 is the lowest rate available to patients. This amount is significantly lower than the facility's gross charge of $10,125 and represents a substantial discount compared to the Medicare benchmark of $5,675.87, which serves as the federal baseline for cost. While commercial insurance plans typically pay higher negotiated rates ranging from $9,112 to $21,279 depending on the carrier, the cash rate can be the most economical option for individuals with high-deductible plans who may not yet have met their coverage thresholds.
Patients should verify if their specific insurance plan falls within the facility's network, as in-network rates for this procedure range from $3,495 to $10,140 across various carriers. It is important to note that while some commercial payers like Healthy Blue Mcaid have a low negotiated rate of $3,495, others such as Tricare and Celtic MCR Adv charge significantly higher amounts of $20,265 and $21,279 respectively. To maximize savings, patients are encouraged to request a self-pay or prompt-pay discount directly from the hospital before scheduling, as these upfront payment incentives can further reduce the final balance. Additionally, because over 80% of hospital bills contain errors, patients should always request a detailed, itemized billing audit rather than accepting a summary statement to ensure accuracy before payment.