CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Garnet Health Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $8,615
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.52x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Garnet Health Medical Center is $8,615. 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 1.52x the Medicare baseline. Located in 707 East Main Street, Middletown, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,615

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: $8,615 (152%)
Ins. Median: $8,615 (152% 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
Aetna $8,615 - $23,388 152%
Blue Cross Blue Shield $8,615 152%
Cdphp $8,615 - $28,779 152%
Cigna $8,615 - $23,551 152%
Emblem Health $8,615 - $28,562 152%
Geisinger Health Plan $8,615 - $19,384 152%
Health First $8,615 152%
Humana $8,615 152%
Mvp $8,615 152%
Prime Health Services $8,615 152%
UnitedHealthcare $8,615 - $24,224 152%
Upmc $8,615 152%
Wellcare $8,744 154%
Fidelis $8,787 155%
Northwell Direct $17,151 302%
Local 1199 $23,388 412%
Magnacare $30,163 531%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 707 East Main Street, Middletown, NY 10940
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals