CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Jefferson Hospital

Billing Code: 392 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$7,231

about 1.3× the $5,676 Medicare rate · typically $5,962–$9,084

modeled estimate · not a bill or quote

What this hospital charges insurers

$5,984

Below the fair price — a good deal

about $1,247 under the fair price · 1.1× Medicare

Medicare pays $5,676 Fair price $7,231 This hospital $5,984

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 $5,984

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 $7,231 (about 1.3× the $5,676 Medicare rate). Jefferson Hospital charges insurers about $5,984 — below the fair price — a good deal. Located in Jefferson Hills, PA.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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
UnitedHealthcaremajor	$5,541 - $5,984	98%
Blue Cross Blue Shieldmajor	$3,642 - $12,108	64%
Aetnamajor	$5,763 - $12,864	102%
Cignamajor	$5,929 - $10,446	104%
Humanamajor	$5,874	103%
AmeriHealth	$5,818	103%
Medical Mutual	$10,446	184%
Molina	$6,040	106%
+ 5 smaller / regional plans	$5,541 - $6,325

Government programs also on file: Medicare.

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, 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 Jefferson Hospital 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 Jefferson Hospital

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.