Digestive disorders treatment (inpatient stay)
Facility: Girard Medical Center
Billing Code: 392 (MS-DRG)
- CPT Billing Code: 392
- Insurance Median: $4,794
- Cash Discount Price: $6,982
- vs. Medicare Baseline: 0.84x 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 |
|---|---|---|
| Blue Cross Blue Shield | $4,794 - $6,962 | 84% |
| Kansas Superior Select-All Plans | $4,794 | 84% |
| Aetna | $4,794 - $8,390 | 84% |
| Humana | $4,794 | 84% |
| Ambetter / Centene | $4,794 | 84% |
| UnitedHealthcare | $4,794 - $11,055 | 84% |
| Medicare (plans) | $4,794 | 84% |
| Multiplan-All Plans | $10,764 | 190% |
| Uhhis-All Plans | $11,055 | 195% |
Consumer Guidance & Cost Commentary
For the procedure "Digestive disorders treatment (inpatient stay)" at Girard Medical Center in Kansas, the facility's cash median price of $6,982 is notably lower than the state average, which typically ranges between 120% and 150% of the Medicare benchmark rate of $5,675.87. While many commercial insurance plans negotiate rates that average 200% to 300% of Medicare, this facility offers a negotiated rate of $4,794 for several payers, including Blue Cross Blue Shield and Humana, which falls below the Medicare benchmark. This suggests that for patients with high-deductible plans, paying the cash price or utilizing the lower negotiated rate may be more cost-effective than relying on standard insurance billing, as the administrative load and contract structures often inflate the baseline price by 20% to 40%.
It is important to note that while the facility is a Critical Access Hospital with a government ownership structure, patients should verify their specific plan details before scheduling, as in-network status does not guarantee the lowest possible price. The data indicates a median negotiated rate of $4,794 across multiple payers, but some plans, such as UnitedHealthcare, have a high-end negotiated rate of $11,055, which exceeds the cash price. To maximize savings, patients should explicitly request "self-pay" or "prompt-pay" discounts prior to check-in, as hospitals often offer fee reductions of 20% to 50% for upfront payment to bypass costly claims processing. Additionally, since over 80% of hospital bills contain errors, consumers are encouraged to request a full itemized