CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Lehigh Valley Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $9,022
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.59x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Lehigh Valley Hospital is $9,022. 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 1.59x the Medicare baseline. Located in 1200 South Cedar Crest Boulevard, Allentown, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$9,022

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: $9,022 (159%)
Ins. Median: $9,022 (159% 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
Populytics $6,774 119%
Amerihealth $6,978 - $7,188 123%
Blue Cross Blue Shield $6,978 - $16,491 123%
Ibc $6,978 123%
UnitedHealthcare $6,978 - $13,754 123%
Highmark Blue Shield $7,118 - $15,413 125%
Cigna $7,188 127%
Geisinger $7,188 - $17,493 127%
Pa Health & Wellness (Allwell) $7,188 127%
Aetna $7,327 - $17,421 129%
Gateway $7,327 129%
Jefferson Health Partners $7,327 - $12,435 129%
Devoted Health $7,397 130%
Humana $7,397 130%
Upmc $7,397 - $16,713 130%
Emblem $7,537 - $15,613 133%
Valley Preferred $14,754 260%
Ambetter / Centene $16,086 283%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 South Cedar Crest Boulevard, Allentown, PA 18103
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals