Digestive disorders treatment (inpatient stay)
Facility: Bob Wilson Memorial Hospital
Billing Code: 392 (MS-DRG)
- CPT Billing Code: 392
- Insurance Median: $9,350
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.65x 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 | $9,350 | 165% |
Consumer Guidance & Cost Commentary
For this procedure at Bob Wilson Memorial Hospital in Ulysses, Kansas, the negotiated rate of $9,350 is significantly higher than the Medicare benchmark of $5,675.87, reflecting a markup of 160%. While this facility is a Critical Access Hospital with a voluntary non-profit, church ownership, the data indicates no specific cash or median paid rates were reported for this service. In cases where a patient has a high deductible or no insurance, paying the cash price directly could be more affordable than using an in-network plan, as commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures. Patients should verify if the facility offers "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can bypass the higher insurance negotiated rates.
It is important to understand that the $9,350 rate represents a contractual ceiling for Blue Cross Blue Shield members, not the full chargemaster list price. If a patient receives care from an out-of-network provider at this facility, they could face balance billing for the difference between the provider's full charge and the insurance allowed amount, though the No Surprises Act protects against such surprise bills for emergency and non-emergency services at in-network hospitals. To avoid unexpected costs, consumers should request a full itemized billing audit rather than accepting a summary bill, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Disputing these errors in writing with the billing supervisor is the most effective way to reduce medical debt and ensure the final invoice accurately reflects the care provided.