CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Newark Beth Israel Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $14,872
Cash Discount Price: $3,470
vs. Medicare Baseline: 2.62x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Newark Beth Israel Medical Center is $14,872. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,470. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 2.62x the Medicare baseline. Located in 201 Lyons Ave, Newark, NJ.

Cash / Self-Pay

$3,470

Average discount available for prompt cash payment at this facility.

Insurance Median

$14,872

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: $3,470 (61%)

Insurance Median: $14,872 (262%)

Cash: $3,470 (61% of Medicare)

Ins. Median: $14,872 (262% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 262% of the Medicare baseline (a markup of 162%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Wellpoint	$1,885 - $8,126	33%
Blue Cross Blue Shield	$5,570 - $19,989	98%
Qualcare Inc	$6,640 - $6,966	117%
Aetna	$8,126 - $25,320	143%
Clover Health	$8,126	143%
Fidelis Care	$8,126	143%
Humana	$8,126	143%
UnitedHealthcare	$8,289 - $21,107	146%
Cigna	$14,522 - $19,435	256%
Amerihealth	$15,222 - $19,082	268%
Emblem Health	$15,370	271%
Wellcare	$16,171	285%

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 $3,470.
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 Newark Beth Israel Medical 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.