CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Mercy Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $7,837
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.38x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Mercy Medical Center is $7,837. 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 1.38x the Medicare baseline. Located in 1000 North Village Avenue, Rockville Centre, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$7,837

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: $7,837 (138%)
Ins. Median: $7,837 (138% 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 $5,251 93%
Brighton $6,454 - $9,258 114%
Blue Cross Blue Shield $7,067 - $18,982 125%
Emblem Health $7,067 - $17,852 125%
Centerlight Healthcare $7,385 130%
Beacon Health Options $7,536 - $10,550 133%
Beacon Health Strategies $7,536 - $10,550 133%
Centers Plan For Healthy Living $7,536 133%
Elderplan Inc. $7,536 133%
Fidelis Care New York $7,536 133%
Healthspring $7,536 133%
Independent Health $7,536 133%
Liberty Health $7,536 133%
Longevity Health Plan $7,536 133%
Medicare (plans) $7,536 - $7,912 133%
Mvp Health Plans $7,536 - $18,030 133%
Orthonet - Uniformed Services Family Health Plan $7,536 133%
Pmc $7,536 133%
Senior Whole Health $7,536 133%
Tricare $7,536 133%
UnitedHealthcare $7,536 - $18,982 133%
Universal Healthcare $7,536 133%
Veterans Affairs $7,536 133%
Zadroga $7,536 133%
Aetna $7,554 - $15,962 133%
Health Plus $7,554 133%
Health First $7,611 - $16,955 134%
Humana $7,686 135%
Agewell New York $7,799 137%
Wellcare Health Plan Inc $7,837 138%
Partners Health Plan $7,912 139%
Centivo $11,687 - $18,030 206%
Local 1199 $14,528 256%
Mail Handlers Benefit Plan $15,962 281%
Meritain Health $15,962 281%
Nippon Life Insurance Company Of America $15,962 281%
Salvation Army $15,962 281%
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 $18,982 334%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 North Village Avenue, Rockville Centre, NY 11571
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals