CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Northside Hospital Duluth

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $17,702
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.38x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Northside Hospital Duluth is $17,702. 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 1.38x the Medicare baseline. Located in 3620 Howell Ferry Road, Duluth, GA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$17,702

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: $17,702 (138%)
Ins. Median: $17,702 (138% 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Us Dept Of Labor Wc $1,340 10%
Blue Cross Blue Shield $3,245 - $18,493 25%
Champus Va $3,353 26%
Tricare $3,357 26%
Kaiser $3,538 - $26,989 28%
Aetna $3,841 - $28,535 30%
Phcs $4,403 34%
UnitedHealthcare $5,000 - $29,752 39%
Cigna $6,294 - $19,048 49%
Georgia Reproductive Specialists $7,034 55%
Genex/Priority Care Solutions $14,256 111%
Streamline Imaging $16,038 125%
Humana $16,766 - $18,678 131%
Corvel Workers Comp $16,929 132%
Employers Choice Network $16,929 132%
Coventry $16,932 - $18,863 132%
Wellcare $17,098 - $19,048 134%
Ambetter / Centene $17,430 - $19,418 136%
Pruitt Health Premier $17,430 - $19,418 136%
Clear Springs Eon Health $17,543 - $18,493 137%
Medicare (plans) $17,543 - $22,192 137%
Va Ccn $17,543 - $18,493 137%
Careiq $17,584 137%
Dekalb_Department Of Health $17,584 137%
Fifa $17,584 137%
Rabun County Boc $17,584 137%
Spreemo $17,584 137%
Georgia Workers Compensation $17,820 139%
One Call Diagnostics $17,820 139%
Caresource $18,420 144%
Clover Health $18,420 144%
Amerigroup $19,233 - $21,634 150%
Northside Health Network $25,603 200%
Oscar $25,679 201%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3620 Howell Ferry Road, Duluth, GA 30096
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals