CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Thomas Jefferson University Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $9,465
  • Cash Discount Price: $9,771
  • vs. Medicare Baseline: 1.67x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Thomas Jefferson University Hospital is $9,465. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,771. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.67x the Medicare baseline. Located in 111 South 11Th Street, Philadelphia, PA.
Cash / Self-Pay
$9,771

Average discount available for prompt cash payment at this facility.

Insurance Median
$9,465

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: $9,771 (172%)
Insurance Median: $9,465 (167%)
Cash: $9,771 (172% of Medicare)
Ins. Median: $9,465 (167% 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) $6,375 - $9,384 112%
Aetna $7,708 - $22,713 136%
Jefferson Health Plan Aca Qhp Exchange $7,829 138%
Inspira Life $8,160 144%
Point Of Comfort Refugee Resettlement $8,160 144%
St Agnes $8,160 144%
Tricare $8,160 144%
UnitedHealthcare $8,160 - $8,813 144%
Humana $8,323 147%
Innovage $8,323 147%
Cigna $8,486 - $22,418 150%
Keystone First Vip Choice $8,486 150%
Ambetter / Centene $8,562 151%
Devoted Health Participation $8,568 151%
Provider Partners Health Plan $8,731 154%
Allwell Pa Health_Wellness Ma $8,976 158%
Highmark Wholecare Gateway $8,976 158%
Perennial $9,465 167%
Ibc Employee Benefit $10,200 180%
Ibc Main Line Health $10,200 180%
Naphcare $10,274 - $13,056 181%
Ibc $12,740 - $24,302 224%
Blue Cross Blue Shield $12,886 - $19,276 227%
Qualcare Jcc $14,084 - $26,244 248%
Highmark $14,313 - $17,735 252%
Upmc Commercial $22,418 395%
Geisinger Health Plan $23,180 408%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 111 South 11Th Street, Philadelphia, PA 19107
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals