Digestive disorders treatment (inpatient stay)
Facility: Kingman Healthcare Center
Billing Code: 392 (MS-DRG)
- CPT Billing Code: 392
- Insurance Median: $3,200
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.56x 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% |
| Medicaid / KanCare | $3,195 - $3,520 | 56% |
| Healthy Blue | $3,195 | 56% |
| UnitedHealthcare | $3,200 | 56% |
| Humana | $3,200 | 56% |
| Celtic Insurance Company | $3,200 - $3,520 | 56% |
| Wellcare | $3,200 | 56% |
| Ambetter / Centene | $3,520 | 62% |
| Blue Cross Blue Shield | $7,171 | 126% |
Consumer Guidance & Cost Commentary
For the inpatient treatment of digestive disorders at Kingman Healthcare Center in Kansas, the negotiated rates across insurance plans range from $1,200 to $7,171, with a median negotiated amount of $3,200. While commercial insurance contracts provide a ceiling on charges, these rates often exceed the facility's cash price, which can be a significant factor for patients with high-deductible plans who may not have met their out-of-pocket limits. It is important to note that the Medicare benchmark for this service is $5,675.87, which serves as the objective baseline for evaluating pricing markups; commercial negotiated rates in this region typically average between 200% and 300% of this federal rate, whereas fair pricing is generally defined as 120% to 150%. Because the facility is a Critical Access Hospital in a rural area, the local wage index influences these benchmarks, and patients should verify their specific plan's allowed amount before scheduling to ensure they are aware of their financial responsibility.
Patients should proactively inquire about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid in full upfront, bypassing the administrative costs associated with insurance claims processing. Since hospitals often default to submitting claims to insurance carriers even when a patient intends to pay out-of-network, it is crucial to request a waiver of insurance submission at registration to secure the lowest possible rate. Additionally, if a patient receives a large bill after using insurance, they should request a detailed, itemized statement to identify any errors, double-billing, or unbundled codes, as over 80% of