CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Saint Vincent Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $6,745
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Saint Vincent Hospital is $6,745. 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 1.19x the Medicare baseline. Located in 232 West 25Th Street, Erie, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,745

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: $6,745 (119%)
Ins. Median: $6,745 (119% 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
Highmark $3,857 - $12,575 68%
Martin'S Point $5,896 104%
Independent Health $6,167 - $7,917 109%
Fidelis $6,334 - $6,597 112%
Life Pittsburgh $6,334 112%
The Health Plan Of The Upper Ohio Valley $6,334 - $6,967 112%
UnitedHealthcare $6,334 - $6,840 112%
Univera $6,334 - $11,717 112%
University Of Pittsburgh Medical Center $6,425 - $6,814 113%
Blue Cross Blue Shield $6,524 115%
Aetna $6,587 - $11,538 116%
Amerihealth $6,650 117%
Highmark Wholecare $6,714 118%
Humana $6,714 118%
Medicare (plans) $6,714 - $7,347 118%
Cigna $6,777 - $10,446 119%
Jefferson Health Plans $6,840 121%
Molina $6,904 122%
American Health Plans $6,967 123%
Medical Mutual $10,446 184%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 232 West 25Th Street, Erie, PA 16544
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals