CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Healthalliance Hospital Marys Avenue Campus

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $7,899
Cash Discount Price: $80,736
vs. Medicare Baseline: 1.39x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Healthalliance Hospital Marys Avenue Campus is $7,899. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80,736. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.39x the Medicare baseline. Located in 105 Mary's Avenue, Kingston, NY.

Cash / Self-Pay

$80,736

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,899

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: $80,736 (1422%)

Insurance Median: $7,899 (139%)

Cash: $80,736 (1422% of Medicare)

Ins. Median: $7,899 (139% 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.

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
First Health	$1,144	20%
Va	$5,266	93%
Magnacare	$7,456 - $7,523	131%
Aetna	$7,523 - $22,166	133%
American Progress	$7,523	133%
Blue Cross Blue Shield	$7,523 - $26,754	133%
Blue Shield Of Ny	$7,523	133%
Cdphp	$7,523 - $20,105	133%
Emblem	$7,523 - $21,652	133%
Hamaspik	$7,523	133%
Health First	$7,523	133%
Mvp	$7,523 - $22,754	133%
Non Contracted	$7,523	133%
Todays Options	$7,523 - $8,275	133%
UnitedHealthcare	$7,523 - $22,383	133%
Wellcare	$7,523	133%
Oxford	$20,145 - $22,383	355%

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 $80,736.
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 Healthalliance Hospital Marys Avenue Campus 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.