CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Wayne Memorial Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $6,594
Cash Discount Price: $20,041
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Wayne Memorial Hospital is $6,594. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20,041. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.16x the Medicare baseline. Located in 601 Park Street, Honesdale, PA.

Cash / Self-Pay

$20,041

Average discount available for prompt cash payment at this facility.

Insurance Median

$6,594

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: $20,041 (353%)

Insurance Median: $6,594 (116%)

Cash: $20,041 (353% of Medicare)

Ins. Median: $6,594 (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
Phcs	$900	16%
Geisinger Health	$1,202	21%
Aarp	$5,067	89%
UnitedHealthcare	$5,067 - $6,594	89%
Upmc	$5,160 - $13,582	91%
Aetna	$5,847	103%
Blue Cross Blue Shield	$6,594 - $12,317	116%
Humana	$6,594 - $6,660	116%
Mvp	$6,594	116%
Tricare	$6,594	116%
Ambetter / Centene	$6,990	123%
Pa Health & Wellness	$6,990	123%
Wellpath	$8,572 - $12,199	151%
Cigna	$11,148	196%

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 $20,041.
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 Wayne Memorial 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.