CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Landmark Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $7,249
Cash Discount Price: $7,585
vs. Medicare Baseline: 1.28x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Landmark Medical Center is $7,249. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,585. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.28x the Medicare baseline. Located in 115 Cass Avenue, Woonsocket, RI.

Cash / Self-Pay

$7,585

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,249

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%)

Cash / Self-Pay: $7,585 (134%)

Insurance Median: $7,249 (128%)

Cash: $7,585 (134% of Medicare)

Ins. Median: $7,249 (128% 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
Neighborhood Health Plan	$6,751 - $7,282	119%
Aetna	$6,879	121%
Tufts Health Plan	$6,879 - $14,034	121%
Ubh	$6,879	121%
UnitedHealthcare	$6,879 - $7,586	121%
Common Wellthcare Alliance	$7,017 - $7,223	124%
Wellcare	$7,017 - $7,965	124%
Tricare	$7,274	128%
Humana	$7,586	134%
Medicare (plans)	$7,586	134%
Employer Direct Healthcare	$9,862	174%
National Healthcare Solutions	$12,137	214%

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 $7,585.
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 Landmark 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.