CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Garnet Health Medical Center

Billing Code: 392 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$13,356

about 2.4× the $5,676 Medicare rate · typically $7,801–$17,908

modeled estimate · not a bill or quote

What this hospital charges insurers

$8,615

Below the fair price — a good deal

about $4,741 under the fair price · 1.5× Medicare

Medicare pays $5,676 Fair price $13,356 This hospital $8,615

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

Highest price of the 9 NY hospitals we have prices for — worth calling around.

Cheapest $5,103 Priciest $8,615

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 $13,356 (about 2.4× the $5,676 Medicare rate). Garnet Health Medical Center charges insurers about $8,615 — below the fair price — a good deal. Located in Middletown, 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	$8,615 - $24,224	152%
Blue Cross Blue Shieldmajor	$8,615	152%
Aetnamajor	$8,615 - $23,388	152%
Cignamajor	$8,615 - $23,551	152%
Humanamajor	$8,615	152%
CDPHP	$8,615 - $28,779	152%
Fidelis Care	$8,787	155%
Geisinger	$8,615 - $19,384	152%
MagnaCare	$30,163	531%
MVP Health Care	$8,615	152%
UPMC Health Plan	$8,615	152%
WellCare	$8,744	154%
+ 4 smaller / regional plans	$8,615 - $28,562

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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 Garnet Health Medical Center 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 Garnet Health Medical Center

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 Mount Vernon Hospital · Mount Vernon $6,829
Montefiore New Rochelle Hospital · New Rochelle $6,861

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