CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: St John's Episcopal Hospital at South Shore

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $10,887
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.92x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at St John's Episcopal Hospital at South Shore is $10,887. 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 1.92x the Medicare baseline. Located in 327 Beach 19Th Street, Far Rockaway, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$10,887

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: $10,887 (192%)
Ins. Median: $10,887 (192% 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
UnitedHealthcare $8,408 - $10,887 148%
Aetna $9,820 - $10,887 173%
Vns $10,343 - $10,887 182%
Blue Cross Blue Shield $10,494 - $13,905 185%
1199 National Benefit Fund $10,560 186%
Cigna $10,642 187%
Centerlight $10,887 192%
Centers Plan For Healthy Living $10,887 192%
Elderplan $10,887 192%
Emblem Health $10,887 - $18,613 192%
Fidelis $10,887 192%
Hamaspik $10,887 192%
Humana $10,887 192%
Longevity $10,887 192%
Lucida $10,887 192%
Metroplus $10,887 192%
Village Care Max $10,887 192%
Wellcare $10,887 192%
Molina $11,976 211%
Magnacare $14,020 247%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 327 Beach 19Th Street, Far Rockaway, NY 11691
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals