CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: St Anthony Community Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $10,523
  • Cash Discount Price: $10,602
  • vs. Medicare Baseline: 1.85x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at St Anthony Community Hospital is $10,523. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,602. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.85x the Medicare baseline. Located in 15 Maple Avenue -19, Warwick, NY.
Cash / Self-Pay
$10,602

Average discount available for prompt cash payment at this facility.

Insurance Median
$10,523

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%)
Cash / Self-Pay: $10,602 (187%)
Insurance Median: $10,523 (185%)
Cash: $10,602 (187% of Medicare)
Ins. Median: $10,523 (185% 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
First Health $1,664 29%
Multiplan $5,836 103%
Aetna $7,068 - $22,557 125%
Blue Cross Blue Shield $7,068 125%
Cdphp $7,068 125%
Emblem $7,068 - $25,894 125%
Fidelis $7,068 125%
Geisinger $7,068 - $16,045 125%
Hamaspik $7,068 125%
Magnacare $7,068 - $29,687 125%
Mvp $7,068 - $25,360 125%
Non Contracted $7,068 125%
Oxford $7,068 - $21,013 125%
Partners Health Plan $7,068 125%
UnitedHealthcare $7,068 - $21,013 125%
Wellcare $7,068 125%
Tricare $7,114 125%
Health First $7,563 133%
World Trade Center $10,523 185%
Cigna $24,179 426%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15 Maple Avenue -19, Warwick, NY 10990
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals