CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Henry Ford Health St John Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $7,543
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.33x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Henry Ford Health St John Hospital is $7,543. 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 1.33x the Medicare baseline. Located in 22101 Moross Rd, Detroit, MI.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,543

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: $7,543 (133%)

Ins. Median: $7,543 (133% 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)	$5,732 - $6,336	101%
Amerihealth Vip Care	$5,974	105%
Aetna	$6,034 - $9,410	106%
Harbor Advantage Hmo	$6,034	106%
Tricare	$6,034	106%
Veterans Choice	$6,034	106%
Humana	$6,094 - $8,400	107%
Meridian Wellcare	$6,336	112%
Molina Advantage	$6,336	112%
Molina Health Link	$6,336	112%
Ambetter / Centene	$7,543	133%
Molina Market Place	$7,543	133%
Ppom	$7,819	138%
Smarthealth	$8,448	149%
Phcs Pos	$9,410	166%
Phcs Ppo	$9,410	166%
Priority Hmo	$9,688	171%
Priority Ppo	$9,688	171%
UnitedHealthcare	$10,828	191%
Aaa-Auto Insurance	$11,465	202%

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 $X.
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 Henry Ford Health St John 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.