CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Fort Hamilton Hughes Memorial Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $10,002
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.76x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Fort Hamilton Hughes Memorial Hospital is $10,002. 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 1.76x the Medicare baseline. Located in 630 Eaton Avenue, Hamilton, OH.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$10,002

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: $10,002 (176%)

Ins. Median: $10,002 (176% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$6,707 - $13,596	118%
Blue Cross Blue Shield	$6,707 - $14,454	118%
Buckeye Health Plan	$6,707 - $11,402	118%
Caresource	$6,707 - $10,366	118%
Cigna	$6,707 - $15,823	118%
Devoted Health	$6,707	118%
Humana	$6,707	118%
Medical Mutual	$6,707 - $16,263	118%
Medigold	$6,707	118%
UnitedHealthcare	$6,707 - $16,418	118%
Valor Health Plan	$6,707	118%
Molina Healthcare	$7,043 - $14,365	124%
Perennial Advantage	$7,043	124%
Custom Design Benefits Inc.	$15,761	278%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 392.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Fort Hamilton Hughes Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 392.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.