CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Penn State Health Lancaster Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $5,525
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.97x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Penn State Health Lancaster Medical Center is $5,525. 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 0.97x the Medicare baseline. Located in 2160 State Road, Lancaster, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,525

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: $5,525 (97%)

Ins. Median: $5,525 (97% 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]	$5,416 - $14,764	95%
Aetna	$5,471 - $14,269	96%
UnitedHealthcare	$5,471 - $16,328	96%
[Amerihealth Caritas]	$5,471	96%
[Cbc]	$5,471 - $13,327	96%
[Geisinger]	$5,471	96%
[Highmark Wholecare]	$5,471	96%
Humana	$5,525	97%
[Healthspring]	$5,525	97%
[Health Partners Plans]	$5,580	98%
[Pa Health & Wellness]	$5,635	99%
[Upmc]	$5,745	101%
[Point Comfort Underwriters]	$6,838	120%
[Highmark Aca]	$11,474	202%
[Highmark Choice Blue]	$11,811	208%
Cigna	$15,226	268%

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 Penn State Health Lancaster 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.