CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: SSM St Joseph Hospital West

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $8,721
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.54x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at SSM St Joseph Hospital West is $8,721. 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 1.54x the Medicare baseline. Located in 100 Medical Plaza, Lake Saint Louis, MO.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,721

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: $8,721 (154%)
Ins. Median: $8,721 (154% 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
Aetna $5,518 - $9,812 97%
Ambetter / Centene $5,518 - $9,812 97%
Health Alliance $5,518 97%
Medica $5,518 - $9,715 97%
Molina Healthcare $5,518 - $9,715 97%
UnitedHealthcare $5,518 - $10,203 97%
Healthlink $5,573 - $14,598 98%
Essence $5,574 - $9,812 98%
Blue Cross Blue Shield $5,601 - $13,760 99%
Humana $5,612 - $9,880 99%
Oscar $9,121 161%
Cigna $9,708 171%
Gateway To Better Health $9,715 171%
Mercy $9,715 171%
New Horizons Pace $9,715 171%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Medical Plaza, Lake Saint Louis, MO 63367
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals