CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Lehigh Valley Hospital - Pocono

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $8,660
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.53x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Lehigh Valley Hospital - Pocono is $8,660. 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 1.53x the Medicare baseline. Located in 206 East Brown Street, East Stroudsburg, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,660

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: $8,660 (153%)
Ins. Median: $8,660 (153% 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
Highmark Blue Shield $6,731 - $13,983 119%
Amerihealth $6,797 120%
Cigna $6,797 - $23,588 120%
Pa Health & Wellness (Allwell) $6,797 120%
UnitedHealthcare $6,863 - $16,831 121%
Aetna $6,929 - $14,194 122%
Gateway $6,929 122%
Geisinger $6,929 - $15,756 122%
Jefferson Health Partners $6,929 - $11,127 122%
Devoted Health $6,995 123%
Humana $6,995 123%
Upmc $6,995 - $14,003 123%
Emblem $7,127 - $12,858 126%
Valley Preferred $14,754 260%
Ambetter / Centene $15,212 268%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 206 East Brown Street, East Stroudsburg, PA 18301
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals