Digestive disorders treatment (inpatient stay)
Facility: Children'S Mercy South
Billing Code: 392 (MS-DRG)
- CPT Billing Code: 392
- Insurance Median: $4,337
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.76x 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 |
|---|---|---|
| UnitedHealthcare | $3,977 | 70% |
| Healthy Blue | $4,242 | 75% |
| Medicaid / KanCare | $4,432 | 78% |
| Blue Cross Blue Shield | $17,330 | 305% |
Consumer Guidance & Cost Commentary
For the procedure "Digestive disorders treatment (inpatient stay)" at Children's Mercy South in Overland Park, KS, the negotiated rates for in-network payers like UnitedHealthcare, Healthy Blue, and Medicaid/KanCare range from $3,977 to $4,432, while the median negotiated rate across all payers is $4,337. These commercial rates are significantly higher than the Medicare benchmark of $5,675.87, which serves as the federal baseline for the true cost of care. It is important to note that while commercial insurance contracts often cap charges, they can sometimes result in higher out-of-pocket costs for patients compared to cash prices, particularly if the patient has a high deductible and the insurance negotiated rate exceeds the facility's cash price. Patients should verify their specific plan's deductible status and allowed amounts before scheduling to avoid unexpected financial burdens.
To minimize costs, patients should proactively inquire about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% for upfront payments. Since hospitals trade a portion of their theoretical profit for immediate liquidity and to bypass costly claims processing, requesting these discounts before check-in is crucial; waiting until after receiving a large post-insurance bill often voids these agreements. Additionally, because over 80% of hospital bills contain errors, patients should request a full itemized, CPT-coded statement rather than accepting a summary bill, allowing them to identify unbundled codes or services not rendered. While the data provided does not include specific county or state average comparisons for this code, understanding that commercial rates often average 200% to 300% of Medicare