CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Grove City Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $6,669
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.17x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Grove City Medical Center is $6,669. 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 1.17x the Medicare baseline. Located in 631 North Broad Street Ext., Grove City, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$6,669

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: $6,669 (117%)

Ins. Median: $6,669 (117% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$1,885 - $6,760	33%
Martin'S Point	$5,896	104%
University Of Pittsburgh Medical Center	$6,148 - $6,669	108%
Allwell	$6,500	115%
Life Pittsburgh	$6,500	115%
UnitedHealthcare	$6,500 - $7,020	115%
Aetna	$6,760 - $10,838	119%
Amerihealth	$6,825	120%
Highmark Wholecare	$6,890	121%
Humana	$6,890	121%
Medicare (plans)	$6,890 - $7,540	121%
Cigna	$6,955 - $12,564	123%
Jefferson Health Plans	$7,020	124%
Molina	$7,085	125%
American Health Plans	$7,150	126%
Medical Mutual	$12,564	221%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 392.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Grove City Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 392.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.