CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: North Shore Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $16,387
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.28x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at North Shore Medical Center is $16,387. 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 1.28x the Medicare baseline. Located in 1100 Nw 95Th St, Miami, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$16,387

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: $16,387 (128%)
Ins. Median: $16,387 (128% 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 $2,169 - $15,607 17%
Dimension Health Wc $2,283 18%
Workers Compensation $2,283 18%
Humana $4,098 - $15,295 32%
Avmed Broad Network $5,082 40%
Veterans Administration Mill Bill $10,925 85%
Tricare $12,309 96%
Medicare (plans) $14,826 - $34,166 116%
Leon Health Inc $15,573 122%
Devoted Health $15,607 122%
UnitedHealthcare $15,607 - $38,617 122%
Veterans Administration Vaccn $15,891 124%
Cigna $16,387 - $22,615 128%
Florida Pace Centers $16,387 128%
Healthsun Health Plans $16,387 128%
Longevity Health Plan $16,686 130%
Oscar Health Plan Hix $17,471 136%
Bright Health Management Commercial $19,069 149%
Centurion Prison $19,508 152%
Self Pay/Uninsured $19,508 152%
Molina Marketplace Program Exchange $19,523 152%
Employer Direct Healthcare $19,864 155%
Bc/Bs Myblue Hmo Hix $22,098 173%
Bc/Bs Of Fl Health Options Hmo $22,098 173%
Bc/Bs Of Fl Simplyblue $22,098 173%
Imagine Health $25,294 197%
Avmed Exchange $27,809 217%
Ambetter / Centene $29,398 230%
Bc/Bs Of Fl Network Blue $30,022 234%
Auto Insurance $31,782 248%
Avmed Select Network $32,462 253%
Bc/Bs Of Fl Blue Select Exchange Non Par $33,024 258%
Amerihealth Caritas Next Exchange $34,166 267%
Bc/Bs Of Fl Phs $41,431 324%
Bc/Bs Of Fl Ppo $41,431 324%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 Nw 95Th St, Miami, FL 33150
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals