Digestive disorders treatment (inpatient stay)
Facility: Oakleaf Surgical Hospital
Billing Code: 392 (MS-DRG)
- CPT Billing Code: 392
- Insurance Median: $5,521
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.97x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $5,521 | 97% |
| Dean Health Plan | $5,521 | 97% |
| Group Health Cooperative Of Eau Claire | $5,521 | 97% |
| Healthpartners | $5,521 | 97% |
| Humana | $5,521 | 97% |
| Medica | $5,521 | 97% |
| Quartz Health Solutions | $5,521 | 97% |
| Security Health Plan Of Wi | $5,521 | 97% |
| Ucare Wi | $5,521 | 97% |
| UnitedHealthcare | $5,521 | 97% |
Consumer Guidance & Cost Commentary
Oakleaf Surgical Hospital, located at 1000 Oakleaf Way in Altoona, Wisconsin, provides inpatient care for digestive disorders treatment. For this service, the facility's median negotiated rate is $5,521, while the Medicare benchmark amount is $5,675.87. The data reflects a vintage of 2026-06 and indicates that ten payers, including Blue Cross Blue Shield and UnitedHealthcare, have submitted rates that align exactly with the negotiated median of $5,521. Since the cash median price is not available in the current dataset, patients with high-deductible plans should inquire about self-pay or prompt-pay discounts directly with the hospital, as these upfront payment options can sometimes result in a lower total cost than the insurance negotiated rate.
The pricing structure for this procedure is consistent across all ten reporting payers, with every carrier showing a high and low rate of $5,521. This uniformity suggests a standardized contract rate for the facility within the region. While the facility is owned by a physician group and classified as an Acute Care Hospital, no specific county or state average was provided in the available data to offer a direct comparative analysis of the facility's pricing against regional norms. Regardless of regional comparisons, it is important for patients to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain potential errors such as unbundled codes or services not rendered, which could significantly reduce the final amount owed.