CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Washington Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $29,540
  • Cash Discount Price: $104,366
  • vs. Medicare Baseline: 2.31x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Washington Hospital is $29,540. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $104,366. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 2.31x the Medicare baseline. Located in 2000 Mowry Ave, Fremont, CA.
Cash / Self-Pay
$104,366

Average discount available for prompt cash payment at this facility.

Insurance Median
$29,540

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: $104,366 (815%)
Insurance Median: $29,540 (231%)
Cash: $104,366 (815% of Medicare)
Ins. Median: $29,540 (231% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 231% of the Medicare baseline (a markup of 131%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Healthnet Comm - All Other Plans $4,672 36%
First Health -All Plans $4,743 37%
Alameda Alliance Ppo-All Other Plans $9,785 76%
Interplan B-4 Ppo-All Other Plans $15,558 121%
Pacific Health Alliance Epo $17,019 133%
Corvel-All Plans $17,453 136%
Pacific Foundation Epo $18,115 141%
Pacific Foundation Ppo-All Other Plans $18,833 147%
Health Net Sr Plus Hmo $19,058 149%
Blue Cross Blue Shield $19,156 - $45,164 150%
Aetna $19,648 - $41,324 153%
Alameda Alliance Mcr Adv $19,648 153%
Blue Shield Mcr Adv $19,648 153%
Brand New Day Mcr Adv - All Plans $19,648 153%
Canopy Mcr Adv $19,648 153%
Central Hlth Mcr Adv - All Plans $19,648 153%
Humana $19,648 - $144,507 153%
Kaiser Mcr Adv $19,648 153%
On Lok Senior Health Services-All Plans $19,648 153%
Tricare $19,648 153%
UnitedHealthcare $19,648 - $104,366 153%
Va (Triwest Ccn)-All Plans $19,648 153%
Cigna $20,987 - $128,451 164%
Canopy-All Other Plans $28,180 220%
Health Net/Healthy Family/Aim $28,901 226%
Kaiser Medi-Cal $31,551 246%
Medi-Cal $31,551 246%
Blue Shield Eppo $74,822 584%
Blue Shield Hmo $82,530 644%
Kaiser - All Other Plans $86,704 677%
Blue Shield Ppo - All Other Plans $110,628 864%
Standford Health Services-All Plans $112,394 878%
County Of Santa Clara-All Plans $120,422 940%
Multiplan Ppo-All Plans $120,422 940%
Cna (Mailhandlers)-All Plans $134,259 1048%
Phcs/Private Healthcare Systems-All Plans $134,259 1048%
Preferred Health Network-All Plans $136,126 1063%
Beech Street-All Plans $136,479 1066%
Interplan B-2 Ppo $136,479 1066%
Masonic Homes Ppo-All Plans $136,479 1066%
Pacific Health Alliance Ppo-All Other Plans $136,479 1066%
Three Rivers Provider Network-All Plans $144,507 1128%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 Mowry Ave, Fremont, CA 94538
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals