CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: St Mary Medical Center

Billing Code: 392 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$8,555

about 1.5× the $5,676 Medicare rate · typically $6,254–$11,864

modeled estimate · not a bill or quote

What this hospital charges insurers

$12,731

Above the fair price

about $4,176 over the fair price · 2.2× Medicare

Medicare pays $5,676 Fair price $8,555 This hospital $12,731 Cash price $15,190

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

Highest price of the 9 PA hospitals we have prices for — worth calling around.

Cheapest $4,806 Priciest $12,731

Black dot = this hospital, among the 9 PA hospitals with a price for this procedure. Full list below.

A fair price for a Digestive disorders treatment (inpatient stay) is about $8,555 (about 1.5× the $5,676 Medicare rate). St Mary Medical Center charges insurers about $12,731, or about $15,190 in cash — above the fair price. Located in Langhorne, PA.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $8,555. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ Blue Cross Blue Shield✓ Aetna✓ Cigna UnitedHealthcareHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
Blue Cross Blue Shieldmajor	$6,447 - $18,326	114%
Aetnamajor	$6,818 - $17,558	120%
Cignamajor	$6,502 - $15,901	115%
Ambetter (Centene)	$11,499	203%
AmeriHealth	$12,731	224%
Oscar Health	$11,595	204%
UPMC Health Plan	$15,901	280%
+ 7 smaller / regional plans	$5,798 - $15,360

Government programs also on file: Medicare.

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 15,190), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 392.

Insurance Before you use insurance

Call your insurance company to confirm St Mary Medical Center is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 392.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at St Mary Medical Center

Compare: Digestive disorders treatment (inpatient stay) at other PA hospitals

Geisinger-Bloomsburg Hospital · Bloomsburg $4,806
Chan Soon- Shiong Medical Center at Windber · Windber $5,364
Penn State Health Lancaster Medical Center · Lancaster $5,471
Meadville Medical Center · Meadville $5,681
Allegheny Valley Hospital · Natrona $5,697
Canonsburg General Hospital · Canonsburg $5,701
Ahn Wexford Hospital · Wexford $5,843
Forbes Hospital · Monroeville $5,907

Insurance negotiated median for the same procedure, sorted lowest first.