CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Encino Hospital Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $19,292
  • Cash Discount Price: $16,922
  • vs. Medicare Baseline: 1.51x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Encino Hospital Medical Center is $19,292. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16,922. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.51x the Medicare baseline. Located in 16237 Ventura Blvd, Encino, CA.
Cash / Self-Pay
$16,922

Average discount available for prompt cash payment at this facility.

Insurance Median
$19,292

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: $16,922 (132%)
Insurance Median: $19,292 (151%)
Cash: $16,922 (132% of Medicare)
Ins. Median: $19,292 (151% 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
Alignment $16,922 132%
Blue Shield Of Ca, Va $16,922 132%
Blue Shield Of Promise $16,922 132%
Health Net Of Ca $16,922 - $30,663 132%
La Care Health Plan $16,922 132%
Managed Health Network $16,922 132%
Medicare (plans) $16,922 132%
Molina $16,922 132%
Renal Payer Solutions $16,922 132%
Tricare $16,922 - $29,258 132%
Usa Senior Care Network $16,922 132%
Brand New Day $17,092 - $20,944 133%
Aids Healthcare Foundation $17,261 135%
Imperial Health Plan Ca $17,938 140%
Corvel $19,292 151%
Zelis Healthcare $19,292 151%
Americas Choice Provider Network $19,698 154%
Multiplan $19,698 154%
Prime Health Services, Inc. $19,698 154%
Three Rivers $19,698 154%
Healthsmart Preferred Care Network $19,901 155%
Provider Select $20,104 157%
Provider Network Of America $20,307 159%
Employer Direct Healthcare $21,999 172%
Aetna $25,812 202%
Workers Comp $26,610 208%
National Healthcare Solutions, Inc (Nhsi) $27,076 211%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 16237 Ventura Blvd, Encino, CA 91436
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals