CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Lowell General Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $7,228
Cash Discount Price: $11,085
vs. Medicare Baseline: 1.27x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Lowell General Hospital is $7,228. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,085. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.27x the Medicare baseline. Located in 295 Varnum Avenue, Lowell, MA.

Cash / Self-Pay

$11,085

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,228

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%)

Cash / Self-Pay: $11,085 (195%)

Insurance Median: $7,228 (127%)

Cash: $11,085 (195% of Medicare)

Ins. Median: $7,228 (127% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Medicare (plans)	$1,971 - $7,368	35%
Aetna	$3,959 - $7,228	70%
Meritain [100063]	$3,959	70%
Elementcare [450046]	$6,359	112%
Champva [800006]	$6,985	123%
UnitedHealthcare	$6,985 - $7,368	123%
Veterans Services [800005]	$6,985	123%
Cigna	$7,228	127%
Fallon Senior [450065]	$7,228 - $7,368	127%
Harvard Pilgrim Stride [450060]	$7,228	127%
Humana	$7,228	127%
Martins Point Generations Replacement [450057]	$7,228	127%
Medicaid / KanCare	$7,228 - $7,368	127%
Neighborhood Pace [450114]	$7,228	127%
Peak Pace Solutions [450115]	$7,228	127%
Secure Horizons Ma Pffs [450077]	$7,228	127%
Veterans Evaluation Svcs [800004]	$7,228	127%
Blue Cross Blue Shield	$7,368	130%
Commonwealth Care Alliance [450067]	$7,368	130%
Wellpoint [100139]	$9,722	171%
Fallon Health Connectorcare [100260]	$11,495	203%
Fallon Health [100259]	$11,495	203%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $11,085.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 392.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Lowell General Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 392.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.