CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Ascension St Vincent's Riverside

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $11,923
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.93x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Ascension St Vincent's Riverside is $11,923. 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 0.93x the Medicare baseline. Located in 1 Shircliff Way, Jacksonville, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$11,923

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: $11,923 (93%)

Ins. Median: $11,923 (93% 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
Coventry Ppo High Performance	$7,266	57%
Coventry Hmo	$8,850	69%
Blue Cross Blue Shield	$9,654 - $24,918	75%
North Florida Surgeons	$10,000	78%
Humana	$10,352 - $16,012	81%
Bc Advantage Mcr Replacement	$10,672	83%
Coventry Mcr Replacement Hmo	$10,672	83%
Heartland Of Hc	$10,672	83%
Medicare (plans)	$10,672 - $10,886	83%
Pace Place	$10,672	83%
Research Study Encore Borland-Groover	$10,672	83%
Veterans Administration	$10,672	83%
Wellcare	$10,672	83%
UnitedHealthcare	$10,779 - $19,683	84%
Careplus Mcr Replacement	$10,886	85%
Cigna	$10,886 - $23,700	85%
Aetna	$10,992 - $38,240	86%
Bright Health	$14,408	113%
Avmed Empower	$14,888	116%
Smarthealth	$14,941	117%
Oscar Health Plan	$17,076	133%
Employer Direct Healthcare	$18,677	146%
90 Degree Benefits	$19,210	150%
Avmed Exchange	$19,210	150%
Molina Exchange	$19,744	154%
Northwell Direct	$20,000	156%
Ambetter / Centene	$20,277	158%
Occunet	$24,013	187%

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 $X.
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 Ascension St Vincent's Riverside 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.