CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Geisinger-Lewistown Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $9,895
Cash Discount Price: $15,060
vs. Medicare Baseline: 1.74x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Geisinger-Lewistown Hospital is $9,895. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15,060. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.74x the Medicare baseline. Located in 400 Highland Avenue, Lewistown, PA.

Cash / Self-Pay

$15,060

Average discount available for prompt cash payment at this facility.

Insurance Median

$9,895

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%)

Cash / Self-Pay: $15,060 (265%)

Insurance Median: $9,895 (174%)

Cash: $15,060 (265% of Medicare)

Ins. Median: $9,895 (174% 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
Geisinger Health Plan	$4,713 - $6,695	83%
Medicare (plans)	$4,713	83%
Upmc Health Plan	$4,713 - $9,278	83%
Advantra	$4,761	84%
Blue Cross Blue Shield	$4,761 - $20,791	84%
Humana	$4,761	84%
Ambetter / Centene	$9,898	174%
Aetna	$11,805 - $15,228	208%
Christian Healthcare Ministries	$12,145	214%
Cigna	$12,777	225%
Christian Health Aid	$19,432	342%
Three Rivers Provider Network Inc.	$19,432	342%
Multiplan	$20,646	364%
Healthsmart Payors Organization	$21,861	385%

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 $15,060.
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 Geisinger-Lewistown 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.