CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Bayshore Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $7,446
Cash Discount Price: $6,620
vs. Medicare Baseline: 1.31x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Bayshore Medical Center is $7,446. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,620. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.31x the Medicare baseline. Located in 727 N Beers St, Holmdel, NJ.

Cash / Self-Pay

$6,620

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,446

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: $6,620 (117%)

Insurance Median: $7,446 (131%)

Cash: $6,620 (117% of Medicare)

Ins. Median: $7,446 (131% 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
Amerihealth	$5,608	99%
Vaccn	$5,733	101%
Horizon	$5,778 - $31,996	102%
Aetna	$6,205 - $21,766	109%
Amerigroup	$6,205	109%
Blue Cross Blue Shield	$6,205	109%
Wellcare	$6,205	109%
United Community/Americhoice	$6,515	115%
Clover	$6,825	120%
Seoul Medical Group	$6,949	122%
UnitedHealthcare	$7,446 - $29,486	131%
Karna	$9,949	175%
Cigna	$21,459 - $23,666	378%
Oxford	$25,313	446%
Brighton Health Plan	$25,686	453%

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 $6,620.
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 Bayshore 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.