CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: AHMC Seton Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $19,805
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.55x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at AHMC Seton Medical Center is $19,805. 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 1.55x the Medicare baseline. Located in 1900 Sullivan Avenue, Daly City, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$19,805

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: $19,805 (155%)
Ins. Median: $19,805 (155% 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
Healthcare Foundation Of San Mateo $1,657 - $1,907 13%
San Mateo County/San Mateo County General Hospital $1,802 14%
Chinese Community Health Plan $2,578 - $19,805 20%
The First Health Network $2,700 21%
Blue Cross Blue Shield $4,165 - $19,805 33%
Cigna $4,204 - $4,673 33%
Blue Shield Of California $4,494 - $19,805 35%
Ahmc Health $4,591 36%
Health Net $5,003 39%
Aetna $5,413 - $19,805 42%
UnitedHealthcare $10,923 - $20,174 85%
Veterans Administration (Va) $14,122 110%
Care Advantage $19,805 155%
For Your Benefit $19,805 155%
Healthnet Seniority $19,805 155%
Humana $19,805 155%
Imperial Health Plan $19,805 155%
Jade Health Care Mg $19,805 155%
Medicare (plans) $19,805 155%
North East Medical Services $19,805 155%
Pacificare $19,805 155%
Canopy Health $20,174 - $45,392 158%
Covid-19 Uninsured Program $20,174 158%
Kaiser $20,174 158%
Easy Choice Hospital Services $20,376 159%
Brand New Day $21,390 - $25,218 167%
Central Health Plan $21,390 167%
Knox-Keene Act $25,218 197%
Workers Compensation Federal $28,115 220%
Athens Administrators $29,768 232%
Corvel Healthcare $29,768 232%
Multiplan/Bce Emergis $29,768 232%
Work Comp Other $29,768 232%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1900 Sullivan Avenue, Daly City, CA 94015
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals