CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Jacobi Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $16,661
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.94x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Jacobi Medical Center is $16,661. 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 2.94x the Medicare baseline. Located in 1400 Pelham Parkway South, Bronx, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$16,661

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: $16,661 (294%)
Ins. Median: $16,661 (294% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 294% of the Medicare baseline (a markup of 194%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Local 1199 $9,796 173%
Cigna $14,628 258%
Emblem $14,922 - $16,661 263%
Healthfirst $15,495 273%
Centerlight $16,328 288%
Aetna $16,661 - $17,387 294%
Blue Cross Blue Shield $16,661 294%
Elderplan $16,661 294%
Fidelis $16,661 - $23,659 294%
Hamaspik $16,661 294%
Oxford $16,661 - $20,683 294%
Senior Whole Health $16,661 - $17,002 294%
Vaccn $16,661 294%
Vnsny $16,661 294%
Wellcare $16,911 298%
Metroplus $17,161 302%
Centers Plan For Healthy Living $17,328 305%
Oscar $17,861 315%
Villagecare Max $18,827 332%
Multiplan $20,260 357%
United $22,072 - $25,550 389%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1400 Pelham Parkway South, Bronx, NY 10461
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals