CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Medical Center Enterprise

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $11,945
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Medical Center Enterprise is $11,945. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 0.93x the Medicare baseline. Located in 400 N Edwards Street, Enterprise, AL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$11,945

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$12,807.1

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $12,807.1 (100%)
Insurance Median: $11,945 (93%)
Ins. Median: $11,945 (93% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $12,807.1 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Health Choice $1,300 10%
Medicaid / KanCare $1,931 15%
Coventry Work Comp Al $2,392 19%
Alamed $2,600 20%
Wc Dept Ind Relations $2,600 20%
Blue Cross Blue Shield $11,345 - $11,587 89%
Humana $11,945 93%
Medicare (plans) $11,945 93%
UnitedHealthcare $11,945 - $21,537 93%
Select Health $12,064 94%
Healthspring $12,183 95%
Node Devoted Health Mcr Adv $12,183 95%
Node Clover Mcr Adv $12,275 96%
Aetna $12,302 96%
Node Va $12,396 97%
Node Wellcare Mcr Adv $12,396 97%
Eon Health $12,540 98%
Cigna $13,471 105%
Ambetter / Centene $16,195 126%
Node Us Dept Of Labor $17,880 140%
Occunet $21,268 166%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 N Edwards Street, Enterprise, AL 36330
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals