CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: St Francis Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $25,612
Cash Discount Price: $66,353
vs. Medicare Baseline: 2.00x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at St Francis Hospital is $25,612. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $66,353. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 2.00x the Medicare baseline. Located in 7Th and Clayton Sts, Wilmington, DE.

Cash / Self-Pay

$66,353

Average discount available for prompt cash payment at this facility.

Insurance Median

$25,612

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: $66,353 (518%)

Insurance Median: $25,612 (200%)

Cash: $66,353 (518% of Medicare)

Ins. Median: $25,612 (200% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Pace-Trinity Health	$2,106	16%
Saint Francis Life	$2,106	16%
Delaware First Health	$5,396	42%
Medicaid / KanCare	$5,827	45%
Blue Cross Blue Shield	$6,604 - $43,175	52%
Cigna	$16,403	128%
Blue Shield - De (Highmark) Medciare Advantage	$16,656	130%
Highmark Health Options Dual Plan	$16,656	130%
Medicare (plans)	$16,656 - $17,040	130%
Aetna	$17,199 - $26,258	134%
Coventry	$17,388	136%
Amerihealth	$25,612	200%
Meritain	$26,258	205%
Trustmark Small Business Benefits	$26,258	205%
Blue Benefit Administrators Of Massachusetts	$43,175	337%
Blue Care Network	$43,175	337%
Blue Distinction Transplant	$43,175	337%
Blue Shield - Ca	$43,175	337%
Blue Shield - Id (Regence)	$43,175	337%
Blue Shield - Ny Highmark Northeastern	$43,175	337%
Blue Shield - Ny Highmark Western	$43,175	337%
Blue Shield - Pa (Highmark)	$43,175	337%
Blue Shield - Wa (Regence)	$43,175	337%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $66,353.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 322.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St Francis Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 322.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.