CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Hospital for Special Surgery

Billing Code: 392 (MS-DRG)

The BaseRate · fair price medium confidence

A fair price for this

$9,987

about 1.8× the $5,676 Medicare rate · typically $7,027–$23,192

modeled estimate · not a bill or quote

What this hospital charges insurers

$21,997

Well above the fair price

about $12,010 over the fair price · 3.9× Medicare

Medicare pays $5,676 Fair price $9,987 This hospital $21,997 Cash price $28,376

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

Highest price of the 9 NY hospitals we have prices for — worth calling around.

Cheapest $5,103 Priciest $21,997

Black dot = this hospital, among the 9 NY hospitals with a price for this procedure. Full list below.

A fair price for a Digestive disorders treatment (inpatient stay) is about $9,987 (about 1.8× the $5,676 Medicare rate). Hospital for Special Surgery charges insurers about $21,997, or about $28,376 in cash — well above the fair price. Located in New York, NY.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $9,987. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

2 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield AetnaCignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$7,265 - $27,469	128%
Blue Cross Blue Shieldmajor	$5,474 - $19,298	96%
GEHA	$21,997	388%
Harvard Pilgrim	$27,469	484%
+ 4 smaller / regional plans	$4,735 - $24,603

Government programs also on file: Medicare.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 28,376), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 392.

Insurance Before you use insurance

Call your insurance company to confirm Hospital for Special Surgery is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 392.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Hospital for Special Surgery

Compare: Digestive disorders treatment (inpatient stay) at other NY hospitals

Sisters of Charity Hospital · Buffalo $5,103
Mercy Hospital of Buffalo · Buffalo $5,610
Kenmore Mercy Hospital · Kenmore $5,857
Community Memorial Hospital, Inc · Hamilton $6,210
United Memorial Medical Center · Batavia $6,279
Montefiore St Luke's Cornwall · Newburgh $6,673
Montefiore Mount Vernon Hospital · Mount Vernon $6,829
Montefiore New Rochelle Hospital · New Rochelle $6,861

Insurance negotiated median for the same procedure, sorted lowest first.