CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: St Catherine of Siena Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $7,090
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at St Catherine of Siena Hospital is $7,090. 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 1.25x the Medicare baseline. Located in 50 Route 25A, Smithtown, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$7,090

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: $7,090 (125%)
Ins. Median: $7,090 (125% 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 $6,617 - $18,460 117%
Centerlight Healthcare $6,617 117%
Aetna $6,752 - $16,024 119%
Beacon Health Options $6,752 - $9,453 119%
Beacon Health Strategies $6,752 - $9,453 119%
Centers Plan For Healthy Living $6,752 119%
Elderplan Inc. $6,752 119%
Emblem Health $6,752 - $17,852 119%
Fidelis Care New York $6,752 119%
Health Plus $6,752 119%
Healthspring $6,752 119%
Independent Health $6,752 119%
Liberty Health $6,752 119%
Longevity Health Plan $6,752 119%
Medicare (plans) $6,752 - $7,090 119%
Mvp Health Plans $6,752 - $14,069 119%
Orthonet - Uniformed Services Family Health Plan $6,752 119%
Pmc $6,752 119%
Senior Whole Health $6,752 119%
Tricare $6,752 119%
UnitedHealthcare $6,752 - $18,460 119%
Universal Healthcare $6,752 119%
Veterans Affairs $6,752 119%
Zadroga $6,752 119%
Health First $6,820 - $15,193 120%
Humana $6,887 121%
Agewell New York $6,989 123%
Wellcare Health Plan Inc $7,022 124%
Partners Health Plan $7,090 125%
Centivo $11,733 - $14,069 207%
Local 1199 $12,490 220%
Apwu $14,069 248%
Cigna $14,069 248%
Daniel H Cook $14,069 248%
Nalc $14,069 248%
Samba $14,069 248%
Mail Handlers Benefit Plan $16,024 282%
Meritain Health $16,024 282%
Nippon Life Insurance Company Of America $16,024 282%
Salvation Army $16,024 282%
Surest $17,387 306%
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%
Self Pay $18,460 325%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 50 Route 25A, Smithtown, NY 11787
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals