CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Brigham and Women's Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $9,364
Cash Discount Price: $28,674
vs. Medicare Baseline: 1.65x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Brigham and Women's Hospital is $9,364. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $28,674. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.65x the Medicare baseline. Located in 75 Francis Street, Boston, MA.

Cash / Self-Pay

$28,674

Average discount available for prompt cash payment at this facility.

Insurance Median

$9,364

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: $28,674 (505%)

Insurance Median: $9,364 (165%)

Cash: $28,674 (505% of Medicare)

Ins. Median: $9,364 (165% 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
Tufts Health Plan [170001]	$7,342	129%
UnitedHealthcare	$7,342	129%
Commonwealth Care Alliance [1007]	$7,491	132%
Aetna	$7,716	136%
Centers Of Excellence [1026]	$9,364	165%
Blue Cross Blue Shield	$9,609	169%
Martin'S Point [160007]	$9,609	169%
Medicare (plans)	$9,609	169%
Mgb Health Plan [150001]	$9,609	169%

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 $28,674.
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 Brigham and Women's 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.