Digestive disorders treatment (inpatient stay)
Facility: Salina Regional Health Center
Billing Code: 392 (MS-DRG)
- CPT Billing Code: 392
- Insurance Median: $18,397
- Cash Discount Price: $14,309
- vs. Medicare Baseline: 3.24x 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 324% of the Medicare baseline (a markup of 224%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $6,485 - $6,826 | 114% |
| Preferred Phsic | $12,265 | 216% |
| Preferred Healthcare - All Other Plans | $16,557 | 292% |
| Providers Care (Wppa)-All Plans | $18,397 | 324% |
| Multiplan (Mpi)-All Plans | $18,397 | 324% |
| Cigna | $18,397 | 324% |
| Aetna | $18,397 | 324% |
Consumer Guidance & Cost Commentary
For the procedure "Digestive disorders treatment (inpatient stay)" at Salina Regional Health Center in Salina, KS, the cash median price is $14,309.00, which is lower than the facility's negotiated rates of $18,397.00 and the gross charge of $20,441.00. While the facility is a voluntary non-profit acute care hospital in ZIP code 67401, patients with high-deductible plans may find paying the cash price directly more affordable than relying on insurance, as the negotiated rates for in-network payers like Preferred Phsic and Preferred Healthcare are significantly higher than the cash option. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, patients should still verify their specific plan details and ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are not inadvertently agreeing to higher insurance-driven rates.
The Medicare benchmark for this service is $5,675.87, which serves as a baseline for evaluating the facility's pricing markup. Although the data does not provide specific county or state average comparisons for this code, the significant difference between the Medicare rate and the cash price highlights the potential for substantial cost savings when paying directly. To avoid unexpected costs, patients should request a full itemized bill rather than accepting a summary invoice, as hospitals may include unbundled codes or charges for services not rendered. If a patient receives a bill that exceeds their expected amount, they should dispute it in writing with the billing supervisor to ensure accuracy, as over 80% of hospital bills contain errors that