CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: St Joseph Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $19,559
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.53x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at St Joseph Medical Center is $19,559. 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 1.53x the Medicare baseline. Located in 2200 E Washington, Bloomington, IL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$19,559

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: $19,559 (153%)

Ins. Median: $19,559 (153% 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
Health Alliance Plan	$14,201 - $25,965	111%
Healthspring	$14,201	111%
Humana	$14,201	111%
Medica	$14,201	111%
Meridian	$14,201	111%
Molina Healthcare	$14,201	111%
Aetna	$14,343 - $19,559	112%
UnitedHealthcare	$14,343 - $27,483	112%
Wellcare	$14,343	112%
Blue Cross Blue Shield	$14,485 - $23,041	113%
Caterpillar	$24,248	189%
Healthlink	$27,520	215%
Cigna	$28,654	224%

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 St Joseph 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.