Digestive disorders treatment (inpatient stay)
Facility: Phillips County Hospital
Billing Code: 392 (MS-DRG)
- CPT Billing Code: 392
- Insurance Median: $7,400
- Cash Discount Price: $6,822
- vs. Medicare Baseline: 1.30x 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 |
|---|---|---|
| Medicaid / KanCare | $3,195 | 56% |
| UnitedHealthcare | $7,400 | 130% |
| Health Partners-All Plans | $8,026 | 141% |
Consumer Guidance & Cost Commentary
For the procedure "Digestive disorders treatment (inpatient stay)" at Phillips County Hospital in Phillipsburg, KS, the facility's negotiated rates range from $3,195 to $8,026 depending on the payer. The lowest negotiated rate of $3,195 is set by Medicaid/KanCare, while the highest rate of $8,026 applies to Health Partners-All Plans. The facility's cash price of $6,822.00 falls between these negotiated amounts. For patients with high-deductible plans or those without insurance, paying the cash price may be more cost-effective than using insurance, as the negotiated rates for some payers exceed the cash price. Patients should verify their specific plan's allowed amount before scheduling to ensure they are not paying more than necessary.
The facility's Medicare benchmark of $5,675.87 serves as a baseline for evaluating pricing fairness, with the cash price representing a 20.9% markup over this federal rate. While the data does not provide specific state or county average comparisons for this specific code, the facility is a Critical Access Hospital owned by the local government. To minimize costs, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% if paid upfront. Additionally, patients should request a full itemized bill to review every charge and ensure no errors or unbundled codes are included before finalizing payment.