CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Bellevue Hospital Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $27,217
Cash Discount Price: Unavailable
vs. Medicare Baseline: 4.80x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Bellevue Hospital Center is $27,217. 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 4.80x the Medicare baseline. Located in 462 First Avenue, New York, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$27,217

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: $27,217 (480%)

Ins. Median: $27,217 (480% 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 480% of the Medicare baseline (a markup of 380%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

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

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Local 1199	$9,796	173%
Oxford	$14,449 - $27,217	255%
Cigna	$14,628	258%
Emblem	$14,922 - $27,217	263%
Aetna	$16,666 - $27,217	294%
Oscar	$17,861	315%
United	$18,395 - $26,673	324%
Multiplan	$20,973	370%
Healthfirst	$25,312	446%
Centerlight	$26,673	470%
Blue Cross Blue Shield	$27,217	480%
Elderplan	$27,217	480%
Hamaspik	$27,217	480%
Senior Whole Health	$27,217 - $28,294	480%
Vaccn	$27,217	480%
Vnsny	$27,217	480%
Wellcare	$27,625	487%
Metroplus	$28,034	494%
Centers Plan for Healthy Living	$28,306	499%
Fidelis	$29,667 - $38,648	523%
Villagecare Max	$30,755	542%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 392.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Bellevue Hospital Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 392.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.