Digestive disorders treatment (inpatient stay)
Facility: Johnson Memorial Hospital
Billing Code: 392 (MS-DRG)
- CPT Billing Code: 392
- Insurance Median: $16,604
- Cash Discount Price: $10,450
- vs. Medicare Baseline: 2.93x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 293% of the Medicare baseline (a markup of 193%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Connecticare | $5,466 - $7,299 | 96% |
| Aetna | $7,748 - $19,857 | 137% |
| Blue Cross Blue Shield | $7,748 - $18,728 | 137% |
| Medicare (plans) | $7,748 - $8,144 | 137% |
| UnitedHealthcare | $7,748 - $7,889 | 137% |
| Harvard Pilgrim Healthcare | $7,889 | 139% |
| Geha | $7,889 | 139% |
| Cca Senior Care Options | $7,903 | 139% |
| Cigna | $7,981 - $10,765 | 141% |
| Fallon Health | $10,279 | 181% |
| Magnacare | $10,765 | 190% |
| Allegiance | $10,765 | 190% |
| Health Partners | $10,765 | 190% |
| Innovative Health Plan II | $16,604 | 293% |
| Diversified Administrators | $16,604 | 293% |
| Claimdoc | $16,604 | 293% |
| Health Choices | $18,728 | 330% |
| Wc Domestic | $18,728 | 330% |
| Unicare | $18,728 | 330% |
| Kaiser Domestic | $18,728 | 330% |
| Bcn Domestic | $18,728 | 330% |
| Blue Shield - Id (Regence) | $18,728 | 330% |
| Blue Shield - Ca | $18,728 | 330% |
| Blue Care Network | $18,728 | 330% |
| Blue Shield - Ny Highmark Western | $18,728 | 330% |
| Blue Shield - Wa (Regence) | $18,728 | 330% |
| Blue Distinction Transplant | $18,728 | 330% |
| Pre-Employment | $18,728 | 330% |
| Blue Shield - Ny Highmark Northeastern | $18,728 | 330% |
| Blue Shield - PA (Highmark) | $18,728 | 330% |
| Wellpoint | $18,728 | 330% |
| Blue Benefit Administrators of Massachusetts | $18,728 | 330% |
| Allied Benefit Systems | $19,857 | 350% |
| Webtpa | $19,857 | 350% |
| Nippon Life Ins | $19,857 | 350% |
| 1199 National Benefit Fund | $19,857 | 350% |
| Meritain | $19,857 | 350% |
| Luminare Health | $19,857 | 350% |
| Gravie Admin Services | $19,857 | 350% |
| Hap | $19,857 | 350% |