CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Montefiore Mount Vernon Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $6,829
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.20x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Montefiore Mount Vernon Hospital is $6,829. 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 1.20x the Medicare baseline. Located in 12 North 7Th Avenue, Mount Vernon, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,829

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: $6,829 (120%)
Ins. Median: $6,829 (120% 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
Blue Cross Blue Shield $6,237 110%
Fidelis $6,237 110%
Healthfirst $6,237 110%
Metroplus $6,237 - $8,108 110%
Point Comfort $6,237 110%
UnitedHealthcare $6,237 - $26,743 110%
Villagecaremax $6,237 110%
Wellcare $6,237 110%
Centerlight $6,424 - $6,549 113%
Elderplan $6,424 113%
Emblem $6,424 - $62,424 113%
Humana $6,424 113%
Amidacare $6,549 115%
Vnsny Choice $6,549 115%
Longevity $6,798 120%
Partners Health Plan $6,861 121%
Molina Healthcare Of Ny Affinity $8,607 152%
Oscar $22,154 390%
Aetna $22,486 - $25,153 396%
Cigna $23,237 - $25,819 409%
American Postal Workers $26,743 471%
Centivo $41,275 727%
Northwell $41,771 736%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12 North 7Th Avenue, Mount Vernon, NY 10550
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals