CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Reading Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $6,898
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.22x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Reading Hospital is $6,898. 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 1.22x the Medicare baseline. Located in 420 S 5Th Avenue, West Reading, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,898

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: $6,898 (122%)
Ins. Median: $6,898 (122% 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
Humana $5,380 - $6,645 95%
UnitedHealthcare $5,380 - $26,506 95%
Highmark $6,264 - $28,348 110%
Upmc $6,329 - $31,692 112%
Blue Cross Blue Shield $6,501 - $19,501 115%
Geisinger $6,512 - $15,592 115%
Amerihealth Caritas $6,519 115%
Health America $6,582 116%
Devoted Health $6,645 117%
Health Partners $6,645 117%
Pa Health & Wellness $6,645 - $10,375 117%
Senior Life $6,835 120%
Aetna $6,962 - $32,693 123%
Cigna $14,407 254%
First Health $23,965 422%
Gateway $23,965 422%
Corvel $32,693 576%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 420 S 5Th Avenue, West Reading, PA 19611
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals