CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Brooks-Tlc Hospital System, Inc

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $7,697
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.36x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Brooks-Tlc Hospital System, Inc is $7,697. 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 1.36x the Medicare baseline. Located in 529 Central Avenue, Dunkirk, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$7,697

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: $7,697 (136%)
Ins. Median: $7,697 (136% 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
Blue Cross Blue Shield $7,697 136%
Humana $7,697 136%
Mvp Health $7,697 136%
Nalc $7,697 136%
Seneca Nation-Lion John Hc $7,697 136%
Total Senior Care $7,697 136%
UnitedHealthcare $7,697 - $9,574 136%
Univera $7,697 136%
Upmc $7,697 - $13,085 136%
Va Community Care Network $7,697 136%
Wellcare $7,928 140%
Independent Health Association $8,510 150%
Emblemhealth $9,558 168%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 529 Central Avenue, Dunkirk, NY 14048
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals