CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Good Samaritan Hospital Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $8,381
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.48x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Good Samaritan Hospital Medical Center is $8,381. 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 1.48x the Medicare baseline. Located in 1000 Montauk Highway, West Islip, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,381

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: $8,381 (148%)
Ins. Median: $8,381 (148% 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.

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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%
Blue Cross Blue Shield $7,178 - $21,305 126%
Centerlight Healthcare $7,178 126%
Brighton $7,286 - $10,185 128%
Centers Plan For Healthy Living $7,325 129%
Elderplan Inc. $7,325 129%
Emblem Health $7,325 - $18,376 129%
Fidelis Care New York $7,325 129%
Healthspring $7,325 129%
Independent Health $7,325 129%
Liberty Health $7,325 129%
Longevity Health Plan $7,325 129%
Medicare (plans) $7,325 - $7,691 129%
Mvp Health Plans $7,325 - $19,123 129%
Orthonet - Uniformed Services Family Health Plan $7,325 129%
Pmc $7,325 129%
Senior Whole Health $7,325 129%
Tricare $7,325 129%
UnitedHealthcare $7,325 - $21,305 129%
Universal Healthcare $7,325 129%
Veterans Affairs $7,325 129%
Zadroga $7,325 129%
Health First $7,398 - $16,481 130%
Humana $7,471 132%
Agewell New York $7,581 134%
Aetna $7,595 - $17,678 134%
Health Plus $7,595 134%
Wellcare Health Plan Inc $7,618 134%
Partners Health Plan $7,691 136%
Centivo $12,941 - $19,123 228%
Local 1199 $14,272 251%
Mail Handlers Benefit Plan $17,678 311%
Meritain Health $17,678 311%
Nippon Life Insurance Company Of America $17,678 311%
Salvation Army $17,678 311%
American Plan Administrators $18,376 324%
Amerihealth Administrators $18,376 324%
Benefit Services $18,376 324%
Ghi Cbp Ny City Employee Alternate $18,376 324%
International Benefit Administrator $18,376 324%
Ultra Benefits Inc. $18,376 324%
Surest $19,092 336%
Apwu $19,123 337%
Cigna $19,123 337%
Daniel H Cook $19,123 337%
Nalc $19,123 337%
Samba $19,123 337%
Self Pay $21,305 375%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Montauk Highway, West Islip, NY 11795
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals