CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Indiana Regional Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $6,479
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Indiana Regional Medical Center is $6,479. 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 1.14x the Medicare baseline. Located in 835 Hospital Road, Indiana, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,479

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: $6,479 (114%)
Ins. Median: $6,479 (114% 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
Medicare (plans) $5,427 96%
Highmark $5,431 - $10,057 96%
Humana $5,990 106%
Highmark Wholecare $6,095 107%
United Mine Workers Of America $6,095 107%
Aetna $6,128 - $9,355 108%
Upmc Health Plan $6,303 - $8,227 111%
Geisinger Health Plan $6,306 - $29,380 111%
Ambetter / Centene $6,308 111%
Amerihealth Caritas $6,308 111%
UnitedHealthcare $6,320 - $8,427 111%
Cigna $9,353 165%
Geisinger $9,752 172%
Pa Health And Wellness Commercial $10,362 183%
Pa Workers Compensation $29,380 518%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 835 Hospital Road, Indiana, PA 15701
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals