CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Montefiore Mount Vernon Hospital

Billing Code: 392 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$9,963

about 1.8× the $5,676 Medicare rate · typically $7,482–$16,844

modeled estimate · not a bill or quote

What this hospital charges insurers

$6,829

Below the fair price — a good deal

about $3,134 under the fair price · 1.2× Medicare

Medicare pays $5,676 Fair price $9,963 This hospital $6,829

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

On the higher side — 6 of 8 other NY hospitals charge less.

Cheapest $5,103 Priciest $6,999

Black dot = this hospital, among the 9 NY hospitals with a price for this procedure. Full list below.

A fair price for a Digestive disorders treatment (inpatient stay) is about $9,963 (about 1.8× the $5,676 Medicare rate). Montefiore Mount Vernon Hospital charges insurers about $6,829 — below the fair price — a good deal. Located in Mount Vernon, NY.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$6,237 - $26,743	110%
Blue Cross Blue Shieldmajor	$6,237	110%
Aetnamajor	$22,486 - $25,153	396%
Cignamajor	$23,237 - $25,819	409%
Humanamajor	$6,424	113%
Fidelis Care	$6,237	110%
Molina	$8,607	152%
Oscar Health	$22,154	390%
WellCare	$6,237	110%
+ 14 smaller / regional plans	$6,237 - $62,424

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 392.

Insurance Before you use insurance

Call your insurance company to confirm Montefiore Mount Vernon Hospital is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 392.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Montefiore Mount Vernon Hospital

Compare: Digestive disorders treatment (inpatient stay) at other NY hospitals

Sisters of Charity Hospital · Buffalo $5,103
Mercy Hospital of Buffalo · Buffalo $5,610
Kenmore Mercy Hospital · Kenmore $5,857
Community Memorial Hospital, Inc · Hamilton $6,210
United Memorial Medical Center · Batavia $6,279
Montefiore St Luke's Cornwall · Newburgh $6,673
Montefiore New Rochelle Hospital · New Rochelle $6,861
Bertrand Chaffee Hospital · Springville $6,999

Insurance negotiated median for the same procedure, sorted lowest first.