CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Mt Sinai Hospital Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $18,871
  • Cash Discount Price: $163,041
  • vs. Medicare Baseline: 1.47x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Mt Sinai Hospital Medical Center is $18,871. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $163,041. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.47x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.
Cash / Self-Pay
$163,041

Average discount available for prompt cash payment at this facility.

Insurance Median
$18,871

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: $163,041 (1273%)
Insurance Median: $18,871 (147%)
Cash: $163,041 (1273% of Medicare)
Ins. Median: $18,871 (147% 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.

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
Lawndale Christian - All Plans $9,516 74%
Hfn Platinum $12,077 94%
Hfn Epo $14,122 110%
Cigna $14,397 - $19,493 112%
UnitedHealthcare $15,279 - $263,345 119%
Blue Cross Blue Shield $16,644 - $21,744 130%
Tricare $17,516 137%
Va Healthnet - All Plans $17,516 137%
Advocate Physician Prtnrs Mcr $18,058 141%
Cenpatico Illinicare Dual $18,058 141%
Cenpatico Illinicare Mcr - All Other Plans $18,058 141%
Harmony Behavioral Htlh - All Plans $18,058 141%
Humana $18,058 - $26,157 141%
Meridian/Harmony D-Snp - All Plans $18,058 141%
Molina Mcaid $18,058 141%
Nextlevel Hlth Icp Fhp Aca - All Plans $18,058 141%
Zing Mcr Adv - All Plans $18,780 147%
Ambetter / Centene $18,961 - $19,864 148%
Molina Mcr - All Other Plans $18,961 148%
Oscar - All Plans $19,504 152%
Advocate Physician Prtnrs - All Other Plans $19,864 155%
Aetna $26,020 203%
Partners In Hlth - All Plans $93,166 727%
Evernorth Behav Hlth Comm - All Other Plans $116,458 909%
Compsych Ip/Op Only - All Plans $139,749 1091%
Healthlink Hmo $153,494 1199%
Multiplan Primary Ntwrk/Phcs - All Other Plans $163,041 1273%
Healthlink Ppo - All Other Plans $164,814 1287%
Multiplan Complementary Ntwrk $186,332 1455%
Hfn Ppo - All Other Plans $204,966 1600%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15Th Street at California, Chicago, IL 60608
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals