Digestive disorders treatment (inpatient stay)
Facility: Wilson Medical Center
Billing Code: 392 (MS-DRG)
- CPT Billing Code: 392
- Insurance Median: $6,007
- Cash Discount Price: $5,239
- vs. Medicare Baseline: 1.06x 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 |
|---|---|---|
| Self Pay Discount | $5,239 | 92% |
| Ebms-All Plans | $5,588 | 98% |
| Aetna | $5,588 | 98% |
| Cigna | $5,588 | 98% |
| Mulitplan-All Plans | $6,426 | 113% |
| Health Partners Of Ks-All Plans | $6,426 | 113% |
| UnitedHealthcare | $6,496 | 114% |
| Blue Cross Blue Shield | $6,627 | 117% |
Consumer Guidance & Cost Commentary
For the procedure "Digestive disorders treatment (inpatient stay)" at Wilson Medical Center in Neodesha, KS, the cash price is $5,239, which is lower than the facility's gross charge of $6,985. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find the cash price more affordable than their insurance negotiated rates, which range from $5,239 to $6,627 depending on the payer. It is important to note that even though some commercial payers like Self Pay Discount have a negotiated rate matching the cash price, other major insurers such as UnitedHealthcare and Blue Cross Blue Shield charge significantly higher amounts. Patients should verify their specific plan's allowed amount before scheduling, as assuming that being in-network guarantees the lowest price can lead to unexpected costs if the insurer's negotiated rate exceeds the cash price.
To ensure you are not overcharged, it is recommended to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. If you receive a balance bill for the difference between the provider's full charge and your insurance payment, you may be protected under the No Surprises Act, which bans balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities. Additionally, if you choose to pay out-of-pocket, ask about prompt-pay discounts, which can reduce the bill by 20% to 50% if paid upfront, bypassing the administrative costs and delays associated with insurance claims processing. Always dispute any surprise bills in writing rather than accepting summary invoices or verbal