CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Ascension St Vincent's Southside

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $12,986
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Ascension St Vincent's Southside is $12,986. 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 1.01x the Medicare baseline. Located in 4201 Belfort Rd, Jacksonville, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$12,986

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: $12,986 (101%)

Ins. Median: $12,986 (101% 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	$9,559 - $24,633	75%
North Florida Surgeons	$10,000	78%
Humana	$10,065 - $16,012	79%
Bc Advantage Mcr Replacement	$10,484	82%
Coventry Mcr Replacement Hmo	$10,484	82%
Medicare (plans)	$10,484 - $10,694	82%
Pace Place	$10,484	82%
Research Study Encore Borland-Groover	$10,484	82%
Veterans Administration	$10,484	82%
Wellcare	$10,484	82%
UnitedHealthcare	$10,589 - $19,683	83%
Careplus Mcr Replacement	$10,694	84%
Cigna	$10,694 - $23,700	84%
Aetna	$10,799 - $40,616	84%
Bright Health	$14,154	111%
Smarthealth	$14,678	115%
Avmed Empower	$14,888	116%
Oscar Health Plan	$16,775	131%
Employer Direct Healthcare	$18,347	143%
90 Degree Benefits	$18,872	147%
Avmed Exchange	$18,872	147%
Molina Exchange	$19,396	151%
Ambetter / Centene	$19,920	156%
Northwell Direct	$20,000	156%
Occunet	$23,589	184%

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 Southside 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.