Digestive disorders treatment (inpatient stay)
Facility: Great Plains Of Sabetha
Billing Code: 392 (MS-DRG)
- CPT Billing Code: 392
- Insurance Median: $1,957
- Cash Discount Price: $1,997
- vs. Medicare Baseline: 0.34x 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 | $1,698 - $3,495 | 30% |
| Great West Healthcare-All Plans | $1,797 | 32% |
| UnitedHealthcare | $1,857 - $1,997 | 33% |
| Century/Wppa/Providers-All Plans | $1,897 | 33% |
| Cigna | $1,897 | 33% |
| Humana | $1,897 | 33% |
| Multiplan-Phcs-All Plans | $1,897 | 33% |
| Federated Mutual Ins-All Plans | $1,917 | 34% |
| Blue Cross Blue Shield | $1,997 | 35% |
| Celtic Mcr Adv | $3,431 | 60% |
| Medicaid / KanCare | $3,495 | 62% |
| Celtic Comm Exchange-All Other Plans | $4,289 | 76% |
Consumer Guidance & Cost Commentary
For this inpatient stay at Great Plains Of Sabetha in Sabetha, KS, the cash price is $1,997, which matches the facility's negotiated rate for most major payers. While the facility's cash price is lower than the gross charge of $1,997 listed in the data, it is important to note that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. In this specific case, the cash price aligns with the lowest negotiated rates found for several insurers, such as Great West Healthcare and Cigna, both at $1,897, though some plans like Medicaid/KanCare have a significantly higher allowed amount of $3,495. Patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the cash rate avoids the administrative markup inherent in the insurance billing cycle.
To minimize costs, patients should proactively request a "self-pay" or "prompt-pay" discount before scheduling their visit, as these upfront payment incentives can reduce the final bill by 20% to 50%. It is crucial to sign a waiver of insurance submission to ensure the hospital applies the cash rate rather than submitting a claim that could void the discount. Additionally, while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should always review their itemized bill for any unbundled codes or services not rendered. Comparing this facility's pricing to state or county averages is not possible with the current data, as no regional benchmarks were provided; however, the facility's cash rate of $1,997 serves as a reliable baseline for patients