CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Karmanos Cancer Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $7,584
Cash Discount Price: $10,565
vs. Medicare Baseline: 1.34x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Karmanos Cancer Center is $7,584. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,565. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.34x the Medicare baseline. Located in 4100 John R, Detroit, MI.

Cash / Self-Pay

$10,565

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,584

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: $10,565 (186%)

Insurance Median: $7,584 (134%)

Cash: $10,565 (186% of Medicare)

Ins. Median: $7,584 (134% 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
Tricare	$5,198 - $5,624	92%
Humana	$5,366 - $5,419	95%
Medicare (plans)	$6,090 - $11,320	107%
Priority Health	$7,640	135%
Mi Amish Medical Board	$8,136	143%
Detroit Medical Center	$8,185	144%
Aetna	$8,186 - $14,243	144%
Cofinity	$8,353	147%
Blue Cross Blue Shield	$9,277 - $10,231	163%
UnitedHealthcare	$18,068	318%

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 $10,565.
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 Karmanos Cancer Center 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.