CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Allegheny General Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $6,018
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Allegheny General Hospital is $6,018. 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 1.06x the Medicare baseline. Located in 320 East North Avenue, Pittsburgh, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,018

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: $6,018 (106%)
Ins. Median: $6,018 (106% 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
Geisinger $2,734 - $5,961 48%
Highmark $3,889 - $14,330 69%
Life Pittsburgh $5,678 100%
The Health Plan Of The Upper Ohio Valley $5,678 - $6,245 100%
UnitedHealthcare $5,678 - $6,132 100%
Martin'S Point $5,896 104%
Aetna $5,905 - $15,503 104%
Amerihealth $5,961 105%
Highmark Wholecare $6,018 106%
Humana $6,018 106%
Medicare (plans) $6,018 - $6,586 106%
Cigna $6,075 - $16,268 107%
Jefferson Health Plans $6,132 108%
Molina $6,188 109%
American Health Plans $6,245 110%
Medical Mutual $16,268 287%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 320 East North Avenue, Pittsburgh, PA 15212
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals