CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Providence Mission Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $17,343
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.35x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Providence Mission Hospital is $17,343. 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 1.35x the Medicare baseline. Located in 27700 Medical Center Rd, Mission Viejo, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$17,343

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: $17,343 (135%)
Ins. Median: $17,343 (135% 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 $17,343 135%
Blue Cross Blue Shield $17,343 - $24,691 135%
Blue Shield $17,343 135%
Brand New Day $17,343 135%
Caremore $17,343 135%
Central Health Plan $17,343 135%
Cigna $17,343 - $51,911 135%
Healthcare Partners $17,343 135%
Healthnet $17,343 - $41,826 135%
Heritage Provider Network $17,343 135%
Humana $17,343 135%
Inland Empire Health Plan $17,343 135%
Kaiser $17,343 135%
Molina $17,343 135%
Monarch Health Plan $17,343 135%
One Care $17,343 135%
Providence Health Plan $17,343 135%
Scan $17,343 135%
UnitedHealthcare $17,343 - $43,361 135%
Wellcare $17,343 135%
Providence $19,873 155%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 27700 Medical Center Rd, Mission Viejo, CA 92691
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals