CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: HCA Florida Lake City Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $14,697
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.15x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at HCA Florida Lake City Hospital is $14,697. 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 1.15x the Medicare baseline. Located in 340 Nw Commerce Dr, Lake City, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$14,697

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: $14,697 (115%)

Ins. Median: $14,697 (115% 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
Molina Healthcare	$2,201 - $13,318	17%
Sunshine State Health Plan	$2,336 - $11,680	18%
Cigna	$2,374 - $99,369	19%
Humana	$4,954 - $54,531	39%
United	$5,063 - $39,605	40%
Hospice Of North Central Fl	$12,478	97%
Wellmed	$13,587	106%
Simply Healthcare	$13,818	108%
Blue Cross Blue Shield	$14,003 - $50,191	109%
Ultimate Health Plan	$14,142	110%
Aetna	$14,211 - $42,781	111%
Simply	$14,558	114%
Oscar	$14,605	114%
American Health Plan	$14,697	115%
Sunshine State	$14,905	116%
Wellcare	$14,905	116%
Gold Kidney Of Florida	$15,113	118%
Centurion	$15,251	119%
Longevity Health Plan	$15,528	121%
Align Senior Care	$15,944	124%
Florida Complete Care	$15,944	124%
Ndms Definitive Care	$17,331	135%
Avmed	$23,106 - $43,853	180%
Evolutions	$28,573	223%

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 HCA Florida Lake City 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.