CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: St Charles Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $7,742
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.36x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at St Charles Hospital is $7,742. 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 200 Belle Terre Road, Port Jefferson, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$7,742

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: $7,742 (136%)
Ins. Median: $7,742 (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
Us Family Health Plan $5,236 92%
Brighton $6,454 - $9,258 114%
Blue Cross Blue Shield $7,221 - $18,112 127%
Emblem Health $7,221 - $17,852 127%
Centerlight Healthcare $7,296 129%
Beacon Health Options $7,444 - $10,422 131%
Beacon Health Strategies $7,444 - $10,422 131%
Centers Plan For Healthy Living $7,444 131%
Elderplan Inc. $7,444 131%
Fidelis Care New York $7,444 131%
Healthspring $7,444 131%
Independent Health $7,444 131%
Liberty Health $7,444 131%
Longevity Health Plan $7,444 131%
Medicare (plans) $7,444 - $7,817 131%
Mvp Health Plans $7,444 - $18,030 131%
Orthonet - Uniformed Services Family Health Plan $7,444 131%
Pmc $7,444 131%
Senior Whole Health $7,444 131%
Tricare $7,444 131%
UnitedHealthcare $7,444 - $18,112 131%
Universal Healthcare $7,444 131%
Veterans Affairs $7,444 131%
Zadroga $7,444 131%
Aetna $7,505 - $16,251 132%
Health Plus $7,505 132%
Health First $7,519 - $16,750 132%
Humana $7,593 134%
Agewell New York $7,705 136%
Wellcare Health Plan Inc $7,742 136%
Partners Health Plan $7,817 138%
Centivo $11,896 - $18,030 210%
Local 1199 $12,490 220%
Mail Handlers Benefit Plan $16,251 286%
Meritain Health $16,251 286%
Nippon Life Insurance Company Of America $16,251 286%
Salvation Army $16,251 286%
American Plan Administrators $17,852 315%
Amerihealth Administrators $17,852 315%
Benefit Services $17,852 315%
Ghi Cbp Ny City Employee Alternate $17,852 315%
International Benefit Administrator $17,852 315%
Ultra Benefits Inc. $17,852 315%
Apwu $18,030 318%
Cigna $18,030 318%
Daniel H Cook $18,030 318%
Nalc $18,030 318%
Samba $18,030 318%
Surest $18,083 319%
Self Pay $18,112 319%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Belle Terre Road, Port Jefferson, NY 11777
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals