CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: United Memorial Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $6,279
Cash Discount Price: $9,044
vs. Medicare Baseline: 1.11x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at United Memorial Medical Center is $6,279. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,044. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.11x the Medicare baseline. Located in 127 North Street, Batavia, NY.

Cash / Self-Pay

$9,044

Average discount available for prompt cash payment at this facility.

Insurance Median

$6,279

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: $9,044 (159%)

Insurance Median: $6,279 (111%)

Cash: $9,044 (159% of Medicare)

Ins. Median: $6,279 (111% 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
Excellus Hmo [104]	$2,806 - $6,279	49%
Fidelis Care New York [112]	$2,806	49%
Molina Healthcare Of Ny [188]	$2,806 - $6,315	49%
Mvp [109]	$2,806 - $6,963	49%
UnitedHealthcare	$2,806 - $9,820	49%
Emblem Ghi [113]	$2,815	50%
Fidelis Exchange [157]	$4,210 - $6,315	74%
Tricare	$5,857	103%
Independent Health Association,In [138]	$5,945 - $6,107	105%
Aetna	$6,150 - $10,527	108%
Highmark [114]	$6,279	111%
Medicare (plans)	$6,279	111%
Veterans Administration [178]	$6,279	111%
Excellus Indemnity [127]	$6,645	117%

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 $9,044.
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 United Memorial 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.