CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: St Elizabeth Edgewood

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $6,722
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.18x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at St Elizabeth Edgewood is $6,722. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.18x the Medicare baseline. Located in 1 Medical Village Drive, Edgewood, KY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,722

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$5,675.87

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $5,675.87 (100%)
Insurance Median: $6,722 (118%)
Ins. Median: $6,722 (118% of 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $5,408 - $19,824 95%
Buckeye Mycare Ohio $6,311 111%
Caresource Ohio $6,311 111%
Healthspring $6,311 111%
Humana $6,311 111%
Molina Mycare Ohio $6,311 111%
UnitedHealthcare $6,438 - $19,226 113%
Devoted $6,627 117%
Wellcare $6,816 120%
Ambetter / Centene $12,623 222%
Caresource $12,623 222%
Employer Advisory Services $14,011 - $15,589 247%
Aetna $18,748 330%
Cigna $20,360 359%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Medical Village Drive, Edgewood, KY 41017
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals