Digestive disorders treatment (inpatient stay)
Facility: Susan B Allen Memorial Hospital
Billing Code: 392 (MS-DRG)
- CPT Billing Code: 392
- Insurance Median: $757
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.13x 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 |
|---|---|---|
| Providrs Care | $757 | 13% |
| Aetna | $8,314 | 146% |
Consumer Guidance & Cost Commentary
For the procedure "Digestive disorders treatment (inpatient stay)" at Susan B Allen Memorial Hospital in El Dorado, KS, the negotiated rates for in-network payers like Aetna and Providrs Care are set at $8,314 and $757 respectively, based on the 2026-06 vintage data. While these commercial rates are significantly higher than the facility's cash median (which is not reported), they remain well below the Medicare benchmark of $5,675.87 for this specific code type. It is important to note that commercial negotiated rates often include administrative overhead and contract premiums that can inflate the final price compared to the true cost of care represented by Medicare. Patients should verify their specific plan's allowed amount, as individual deductibles and co-pays can further influence out-of-pocket costs before any negotiated rate is applied.
To minimize potential financial exposure, patients should proactively request a "self-pay" or "prompt-pay" discount before scheduling, as these upfront payment incentives can reduce the total bill by 20% to 50% by bypassing insurance claim processing fees. If you have a high-deductible plan, paying the cash price directly might be more economical than relying on insurance, especially if the negotiated rate exceeds your expected out-of-pocket maximum. Additionally, since this facility is an in-network provider, the No Surprises Act protects you from unexpected balance billing for emergency services or out-of-network ancillary providers like emergency physicians or labs. Always demand a detailed, itemized bill before paying to ensure no unbundled codes or services not rendered are included in the final charge.