Digestive disorders treatment (inpatient stay)
Facility: Wamego Health Center
Billing Code: 392 (MS-DRG)
- CPT Billing Code: 392
- Insurance Median: $3,623
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.64x 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 |
|---|---|---|
| UnitedHealthcare | $3,484 | 61% |
| Medicaid / KanCare | $3,623 - $3,658 | 64% |
| Aetna | $3,623 | 64% |
| Blue Cross Blue Shield | $9,419 - $9,914 | 166% |
Consumer Guidance & Cost Commentary
For the procedure "Digestive disorders treatment (inpatient stay)" at Wamego Health Center in Wamego, KS, the facility's negotiated rate of $3,623 is significantly lower than the highest commercial payer rates, such as Blue Cross Blue Shield's range of $9,419 to $9,914. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the data does not provide specific county or state average benchmarks for this service, so a direct comparison to regional pricing norms cannot be made from the available information. Patients should note that while Medicaid/KanCare plans have a narrow range of $3,623 to $3,658, the Medicare benchmark for this code is $5,675.87, which serves as a scientifically validated baseline for evaluating the true cost of care rather than the hospital's inflated chargemaster list.
Although cash and negotiated rates are not explicitly listed in the dataset for this specific service, patients with high-deductible plans may find that paying out-of-pocket is more cost-effective if the insurance negotiated rate exceeds the cash price, which is common when administrative overhead inflates commercial rates. It is crucial to verify "self-pay" or "prompt-pay" discounts directly with the hospital before scheduling, as these upfront payment incentives can bypass the costly claims processing cycle and reduce overall costs by 20% to 50%. Furthermore, under the No Surprises Act, patients are protected from balance billing for out-of-network services at in-network facilities, meaning they should never pay the difference between a provider's full list price and their insurance allowed amount for emergency or non-emergency care at this location.