CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: UNM Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $11,112
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.96x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at UNM Hospital is $11,112. 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 1.96x the Medicare baseline. Located in 2211 Lomas Boulevard Ne, Albuquerque, NM.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$11,112

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: $11,112 (196%)

Ins. Median: $11,112 (196% 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
Presbyterian Network	$2,055 - $22,224	36%
UnitedHealthcare	$2,733 - $11,112	48%
Humana	$2,772 - $10,556	49%
Blue Cross Blue Shield	$8,509 - $11,112	150%
Aetna	$11,112	196%
Alamo Navajo School Board	$11,112	196%
Indian Health Abq	$11,112	196%
Kewa Pueblo Health Corporation	$11,112	196%
Pueblo Of Isleta	$11,112	196%
Pueblo Of Jemez	$11,112	196%
Pueblo Of Sandia	$11,112	196%
Christus	$12,779	225%
Christus Health Exchange Plan	$12,779	225%
Devoted Health	$13,335	235%
Imperial Health Exchange	$18,891	333%
Albuquerque Public Schools	$22,224	392%

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 $X.
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 UNM 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.