CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Duke University Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $7,494
Cash Discount Price: $5,839
vs. Medicare Baseline: 1.32x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Duke University Hospital is $7,494. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,839. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.32x the Medicare baseline. Located in 2301 Erwin Rd, Durham, NC.

Cash / Self-Pay

$5,839

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,494

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: $5,839 (103%)

Insurance Median: $7,494 (132%)

Cash: $5,839 (103% of Medicare)

Ins. Median: $7,494 (132% 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
Sentara	$3,209	57%
Aetna	$4,237 - $8,436	75%
Humana	$4,378 - $8,498	77%
Troy Health	$5,150	91%
Voans	$5,150	91%
Cigna	$5,253 - $21,471	93%
Liberty	$5,253	93%
Alliance Health	$7,494	132%
Amerihealth	$7,494	132%
Blue Cross Blue Shield	$7,494 - $10,654	132%
Carolina Complete Health	$7,494	132%
Partners	$7,494	132%
Trillium	$7,494	132%
UnitedHealthcare	$7,868 - $14,413	139%
Medcost	$9,147	161%

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 $5,839.
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 Duke University 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.