CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Loyola Gottlieb Memorial Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $15,356
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.20x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Loyola Gottlieb Memorial Hospital is $15,356. 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 1.20x the Medicare baseline. Located in 701 West North Ave, Melrose Park, IL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$15,356

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: $15,356 (120%)

Ins. Median: $15,356 (120% 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
Blue Cross Blue Shield	$13,792 - $20,824	108%
Aetna	$14,219 - $22,552	111%
Vaccn United	$14,219	111%
Humana	$14,546 - $24,203	114%
Cigna	$14,645 - $23,910	114%
Ambetter / Centene	$14,930	117%
Molina	$14,930	117%
Wellcare	$14,930	117%
Meridian	$15,356	120%
Oscar Ifp	$15,641	122%
Molina Marketplace Ifp	$17,773	139%
UnitedHealthcare	$23,342 - $25,372	182%

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 Loyola Gottlieb Memorial 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.