CMS Price Transparency Data
Heart stent placement (inpatient stay)
Facility: Mercy Hospital Fort Smith
Billing Code: 322 (MS-DRG)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 322
- Insurance Median: $13,460
- Cash Discount Price: $35,728
- vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Mercy Hospital Fort Smith is $13,460. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35,728. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.05x the Medicare baseline. Located in 7301 Rogers Ave, Fort Smith, AR.
Cash / Self-Pay
$35,728
Average discount available for prompt cash payment at this facility.
Insurance Median
$13,460
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%)
Cash / Self-Pay: $35,728 (279%)
Insurance Median: $13,460 (105%)
Cash: $35,728 (279% of Medicare)
Ins. Median: $13,460 (105% 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.
Input your details and click calculate to compare out-of-pocket costs.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $10,250 - $18,688 | 80% |
| Humana | $10,250 - $16,833 | 80% |
| Medicaid / KanCare | $10,250 - $12,826 | 80% |
| Private Health Care Systems Contracted [320320] | $10,536 | 82% |
| Private Health Care Systems [20320] | $10,536 | 82% |
| Ambetter / Centene | $12,826 | 100% |
| Home State Health Plan Contracted [320187] | $12,826 | 100% |
| Novasys Contracted [320285] | $12,826 | 100% |
| American Health Advantage Of Mo Mcr [20264] | $13,460 | 105% |
| Blue Cross Blue Shield | $13,460 - $19,217 | 105% |
| Cross Timbers Hospice [20098] | $13,460 | 105% |
| Elara Caring Aspire Hospice Contracted [320433] | $13,460 | 105% |
| Elara Caring Aspire Hospice [20433] | $13,460 | 105% |
| Globalhealth Contracted [320145] | $13,460 | 105% |
| Halo Hcr Inc Hospice Contracted [320432] | $13,460 | 105% |
| Halo Hcr Inc Hospice [20432] | $13,460 | 105% |
| Independent Health [20197] | $13,460 | 105% |
| Jordan Valley Senior Care Pace [20515] | $13,460 | 105% |
| Kindful Hospice Contracted [320434] | $13,460 | 105% |
| Kindful Hospice [20434] | $13,460 | 105% |
| Medical Associates Health [20444] | $13,460 | 105% |
| Medicare (plans) | $13,460 - $14,794 | 105% |
| Mercy Hospice Okc [20252] | $13,460 | 105% |
| Pace Of The Ozarks [20518] | $13,460 | 105% |
| Provider Partners Health Plans Contracted [320450] | $13,460 | 105% |
| Qual Choice Contracted [320325] | $13,460 | 105% |
| Spina Bifida Hlthcare Benefit [20506] | $13,460 | 105% |
| Tribute Health Plan Mcr [20338] | $13,460 | 105% |
| UnitedHealthcare | $13,460 - $22,046 | 105% |
| Valir Pace [20503] | $13,460 | 105% |
| Wellfirst Health Mcr [20443] | $13,460 | 105% |
| Cherokee Nation Health Serv Contracted [320066] | $14,215 | 111% |
| Dept Of Veteran Affairs Contracted [320106] | $14,215 | 111% |
| Indian Health Service Contracted [320198] | $14,215 | 111% |
| Indian Health Service [20198] | $14,215 | 111% |
| Cigna | $14,490 - $20,114 | 113% |
| Employers Health Coalition Contracted [320116] | $17,512 | 137% |
| Aither Health Contracted [320449] | $18,157 | 142% |
| Edison Health Solutions Contracted [320502] | $18,157 | 142% |
| Mercy Benefit Admin Contracted [320251] | $18,157 | 142% |
| Usable Contracted [320409] | $19,217 | 150% |
| Tricare | $21,472 | 168% |
| United Medical Resources Contracted [320454] | $22,046 | 172% |
| Health Choice Contracted [320166] | $22,168 | 173% |
| Qual Choice Contracted [320324] | $22,570 | 176% |
| First Health Contracted [320128] | $22,642 | 177% |