CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Jefferson Healthcare

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $11,508
Cash Discount Price: $11,570
vs. Medicare Baseline: 2.03x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Jefferson Healthcare is $11,508. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,570. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 2.03x the Medicare baseline. Located in 834 Sheridan Street, Port Townsend, WA.

Cash / Self-Pay

$11,570

Average discount available for prompt cash payment at this facility.

Insurance Median

$11,508

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: $11,570 (204%)

Insurance Median: $11,508 (203%)

Cash: $11,570 (204% of Medicare)

Ins. Median: $11,508 (203% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 203% of the Medicare baseline (a markup of 103%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Chpw Mcaid	$8,955	158%
Molina Mcaid	$8,955	158%
Amerigroup Mcaid-All Plans	$9,217	162%
Tricare	$9,316	164%
Coord Care Mcaid Ip/Op Only	$9,390	165%
Regence-All Other Plans	$10,846	191%
Aetna	$10,960 - $13,016	193%
Molina Mcr Adv	$10,960	193%
Medicare (plans)	$11,179	197%
Chpw Mcr Adv	$11,837	209%
Chpw Commercial-All Other Plans	$12,293	217%
Premera-All Plans	$12,293	217%
Cigna	$13,016	229%
Coord Care Cascade Ip/Op Only	$13,016	229%
Coord Care Comm/Exchge-All Other Plans	$13,016	229%
Molina Marketplace-All Other Plans	$13,700	241%
UnitedHealthcare	$15,248	269%

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 $11,570.
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 Jefferson Healthcare 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.