CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Mercyone Dubuque Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $13,138
Cash Discount Price: $46,576
vs. Medicare Baseline: 1.03x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Mercyone Dubuque Medical Center is $13,138. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46,576. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.03x the Medicare baseline. Located in 250 Mercy Drive, Dubuque, IA.

Cash / Self-Pay

$46,576

Average discount available for prompt cash payment at this facility.

Insurance Median

$13,138

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%)

Cash / Self-Pay: $46,576 (364%)

Insurance Median: $13,138 (103%)

Cash: $46,576 (364% of Medicare)

Ins. Median: $13,138 (103% 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
Iowa Total Care	$11,023	86%
Medicaid / KanCare	$11,131 - $11,174	87%
Aetna	$12,623	99%
Medicare (plans)	$12,623 - $13,138	99%
Blue Cross Blue Shield	$12,749	100%
UnitedHealthcare	$12,875 - $19,839	101%
Amish Hospital Aid	$17,131	134%
Oscar	$18,253	143%
Wps	$18,971	148%
Geha	$19,839	155%
Ambetter / Centene	$21,639	169%
Centivo	$23,210	181%
Claimdoc	$25,890	202%
Nova	$25,890	202%

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 $46,576.
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 Mercyone Dubuque Medical Center 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.