CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Kaleida Health

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $9,388
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.65x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Kaleida Health is $9,388. 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 1.65x the Medicare baseline. Located in 100 High Street, Buffalo, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$9,388

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: $9,388 (165%)
Ins. Median: $9,388 (165% 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
Tricare $8,919 157%
Independent Health Association $9,069 - $9,388 160%
Independent Health Association - Wchob $9,069 160%
Univera $9,200 162%
Univera - Wchob $9,200 162%
Blue Cross Blue Shield $9,388 165%
Cigna $9,388 165%
Fallon Health $9,388 165%
Kalos Health $9,388 165%
UnitedHealthcare $9,388 - $9,576 165%
Vns $9,388 165%
Wellcare $9,388 165%
Fidelis $9,857 174%
Aetna $9,951 - $16,849 175%
Centers Plan For Healthy Living $9,951 175%
Upmc $10,139 179%
Magnacare $10,696 188%
Ghi/Emblem Health $11,241 198%
Ghi/Emblem Health - Wchob $11,570 204%
Magnacare - Wchob $14,137 249%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 High Street, Buffalo, NY 14210
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals