Digestive disorders treatment (inpatient stay)
Facility: Scott County Hospital
Billing Code: 392 (MS-DRG)
- CPT Billing Code: 392
- Insurance Median: $2,347
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.41x 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 |
|---|---|---|
| Wppa | $1,200 | 21% |
| UnitedHealthcare | $3,495 | 62% |
Consumer Guidance & Cost Commentary
For this inpatient stay at Scott County Hospital in Scott City, Kansas, the negotiated rates for digestive disorders treatment range from $1,200 to $3,495 depending on your specific insurance plan. While the facility is a Critical Access Hospital owned by a voluntary non-profit, the data indicates that cash-pay options are not available for this service. It is important to note that commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures; however, since no cash or self-pay rates are listed here, patients should verify with the hospital whether "self-pay" or "prompt-pay" discounts might apply if they choose to pay out-of-pocket.
To understand the true cost of this care, it is helpful to compare these figures against the Medicare benchmark, which serves as the federal baseline for hospital pricing. The Medicare amount for this procedure is $5,675.87, and the median negotiated rate paid by payers is $2,347.00. Although the negotiated rate is lower than the Medicare amount in this specific dataset, patients should be aware that balance billing is generally prohibited for in-network services under the No Surprises Act, meaning they should not expect to be billed for the difference between the hospital's full chargemaster and the insurance payment. If you receive an unexpected bill, you should request a formal itemized audit to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through written dispute.