CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: HCA Florida Orange Park Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $18,315
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.43x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at HCA Florida Orange Park Hospital is $18,315. 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 1.43x the Medicare baseline. Located in 2001 Kingsley Ave, Orange Park, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$18,315

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: $18,315 (143%)

Ins. Median: $18,315 (143% 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
Avmed	$1,440 - $38,367	11%
Molina Healthcare	$1,834 - $11,098	14%
Cigna	$2,109 - $34,814	16%
Sunshine State Health Plan	$2,348 - $11,736	18%
United	$5,749 - $44,816	45%
Humana	$7,707 - $47,702	60%
Simply Healthcare	$13,677 - $19,041	107%
Hospice Community	$16,321	127%
Oscar	$17,251	135%
United Behavioral Health	$18,134	142%
Veterans Evaluation Services	$18,134	142%
Wellmed	$18,225	142%
Blue Cross Blue Shield	$18,315 - $49,855	143%
Careplus	$18,315 - $20,854	143%
Sunshine State	$18,315	143%
Wellcare	$18,315	143%
Devoted Health	$18,497	144%
Optimum Healthcare	$18,859	147%
Florida Complete Care	$19,041	149%
American Health Plan	$19,222	150%
Medicare (plans)	$19,585	153%
Gold Kidney	$19,766	154%
Positive Healthcare	$19,766	154%
Longevity	$19,948	156%
Clay County Sheriffs Office	$22,668	177%
Ndms Definitive Care	$22,668	177%
Aetna	$32,033 - $39,095	250%

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 Orange Park 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.