Digestive disorders treatment (inpatient stay)
Facility: Cloud County Health Center
Billing Code: 392 (MS-DRG)
- CPT Billing Code: 392
- Insurance Median: $16,007
- Cash Discount Price: $11,795
- vs. Medicare Baseline: 2.82x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 282% of the Medicare baseline (a markup of 182%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 | $15,165 - $15,670 | 267% |
| Mpi-All Plans | $16,007 | 282% |
| Pponext-All Plans | $16,007 | 282% |
| Health Partners - All Plans | $16,007 | 282% |
Consumer Guidance & Cost Commentary
For the procedure "Digestive disorders treatment (inpatient stay)" at Cloud County Health Center in Concordia, KS, the facility's negotiated rates range from $15,165 to $16,007 depending on the insurance plan. This price point is significantly higher than the Medicare benchmark of $5,675.87, reflecting the standard administrative markup and contract structures that commercial insurers utilize. While the facility offers a cash payment option at a median price of $11,795, which is lower than the negotiated rates, patients with high-deductible plans should verify if their specific insurance coverage would result in out-of-pocket costs exceeding this cash amount. It is important to note that commercial rates often include administrative overhead and do not represent the lowest possible cost, as the cash price can sometimes be more economical for those who do not have active insurance coverage.
To ensure you receive the most accurate pricing, we recommend contacting the hospital directly to confirm their "self-pay" or "prompt-pay" discount policies, which can reduce the final bill by 20% to 50% if paid upfront. Additionally, since over 80% of hospital bills contain errors, we strongly advise requesting a detailed, itemized statement before agreeing to any payment plan or finalizing a balance. This allows you to review specific charges for services rendered and identify any potential double-billing or unbundled codes. By comparing the facility's rates against the Medicare benchmark and understanding the difference between negotiated and cash prices, you can make informed decisions about your healthcare spending without relying on the inflated chargemaster lists often displayed online.