CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Portsmouth Regional Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $7,709
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.36x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Portsmouth Regional Hospital is $7,709. 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 1.36x the Medicare baseline. Located in 333 Borthwick Ave, Portsmouth, NH.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$7,709

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: $7,709 (136%)
Ins. Median: $7,709 (136% 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
Harvard Pilgrim $4,602 - $5,752 81%
Granite State Health $5,518 97%
Amerihealth Caritas $5,627 99%
Well Sense Health Plan $5,791 102%
Tufts Health Plan $6,332 112%
United $7,539 133%
Aetna $7,709 136%
Humana $7,709 136%
United Behavioral Health $7,709 136%
United Va Ccn $7,709 136%
Blue Cross Blue Shield $7,863 - $31,450 139%
Cigna $7,863 - $24,417 139%
Martin'S Point Health $8,017 141%
Ambetter / Centene $9,393 165%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 333 Borthwick Ave, Portsmouth, NH 03801
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals