CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Queens Hospital Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $29,308
Cash Discount Price: Unavailable
vs. Medicare Baseline: 5.16x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Queens Hospital Center is $29,308. 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 5.16x the Medicare baseline. Located in 82-68 164Th Street, Jamaica, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$29,308

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: $29,308 (516%)

Ins. Median: $29,308 (516% 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 516% of the Medicare baseline (a markup of 416%). 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	$12,714 - $29,308	224%
Cigna	$14,628	258%
Emblem	$14,922 - $29,308	263%
Aetna	$16,073 - $29,308	283%
United	$16,187 - $18,738	285%
Oscar	$17,861	315%
Multiplan	$19,545	344%
Healthfirst	$27,257	480%
Centerlight	$28,722	506%
Senior Whole Health	$29,304 - $29,308	516%
Blue Cross Blue Shield	$29,308	516%
Elderplan	$29,308	516%
Hamaspik	$29,308	516%
Vaccn	$29,308	516%
Vnsny	$29,308	516%
Wellcare	$29,748	524%
Metroplus	$30,187	532%
Centers Plan For Healthy Living	$30,480	537%
Villagecare Max	$33,118	583%
Fidelis	$34,584 - $41,618	609%

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 Queens 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.