CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Lancaster General Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $6,599
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Lancaster General Hospital is $6,599. 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 1.16x the Medicare baseline. Located in 555 North Duke Street, Lancaster, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$6,599

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: $6,599 (116%)

Ins. Median: $6,599 (116% 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
Hospice And Community Care	$1,042	18%
Hospice Generic	$1,097	19%
Highmark	$6,194 - $20,430	109%
Albright Life	$6,285	111%
Coatesville Va	$6,285	111%
Lebanon Veterans Hospital	$6,285	111%
UnitedHealthcare	$6,285	111%
Aetna	$6,348 - $47,021	112%
Blue Cross Blue Shield	$6,379 - $20,421	112%
Amerihealth Caritas	$6,411	113%
Cigna	$6,474 - $15,714	114%
Health Partners Mcr Advantage	$6,474	114%
Medicare (plans)	$6,499 - $6,914	115%
Devoted Health	$6,599	116%
Pa Health And Wellness Mcr	$6,599	116%
Elap Employees	$9,228	163%
Oscar Health Plan	$12,256	216%
Claim Watcher Plus	$12,319	217%
Medicaid / KanCare	$12,712	224%
Gift Of Life Donor Program	$13,500	238%
Claim Watcher	$13,827	244%
Highmark Commercial Preferred	$16,419	289%
Elap Other Groups	$21,446	378%
Highmark Commercial Non-Preferred	$24,774	436%
Workers Compensation	$29,380	518%

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 $X.
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 Lancaster General 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.