CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: UPMC Jameson

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $6,536
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.15x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at UPMC Jameson is $6,536. 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 1.15x the Medicare baseline. Located in 1211 Wilmington Avenue, New Castle, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,536

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: $6,536 (115%)
Ins. Median: $6,536 (115% 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
Occunet $1,500 26%
Aetna $6,052 107%
Humana $6,052 107%
UnitedHealthcare $6,052 - $7,938 107%
Cigna $6,197 - $6,536 109%
Amerihealth Caritas $6,536 115%
Highmark Wholecare (Prev Gateway) $6,536 115%
Pa Health & Wellness $6,536 115%
Upmc Health Plan $6,584 - $7,765 116%
Blue Cross Blue Shield $7,450 131%
Upmc Work Partners $27,709 - $32,958 488%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1211 Wilmington Avenue, New Castle, PA 16105
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals