CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Unitypoint Health - Meriter

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $8,420
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.48x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Unitypoint Health - Meriter is $8,420. 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 1.48x the Medicare baseline. Located in 202 S Park St, Madison, WI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,420

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: $8,420 (148%)
Ins. Median: $8,420 (148% 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.

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
Aspirus $6,450 114%
Blue Cross Blue Shield $6,450 - $19,382 114%
Humana $6,450 114%
Illinicare $6,450 114%
Meridiancare $6,450 114%
Prevea 360 $6,450 114%
UnitedHealthcare $6,450 - $12,395 114%
Medical Associates Health Plan $7,998 141%
Quartz $8,842 156%
Cigna $15,684 276%
Health Partners Open Network $17,446 307%
Wellmark Uph Self-Funded $19,382 341%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 202 S Park St, Madison, WI 53715
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals