CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Jefferson Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $5,984
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Jefferson Hospital is $5,984. 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 1.05x the Medicare baseline. Located in 565 Coal Valley Road, Jefferson Hills, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,984

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: $5,984 (105%)
Ins. Median: $5,984 (105% 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 $3,642 - $12,108 64%
Life Pittsburgh $5,541 98%
UnitedHealthcare $5,541 - $5,984 98%
Aetna $5,763 - $12,864 102%
Amerihealth $5,818 103%
Highmark Wholecare $5,874 103%
Humana $5,874 103%
Medicare (plans) $5,874 - $6,428 103%
Martin'S Point $5,896 104%
Cigna $5,929 - $10,446 104%
Jefferson Health Plans $5,984 105%
Molina $6,040 106%
University Of Pittsburgh Medical Center $6,067 - $6,325 107%
American Health Plans $6,095 107%
Medical Mutual $10,446 184%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 565 Coal Valley Road, Jefferson Hills, PA 15025
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals