CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Presence Mercy Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $15,457
  • Cash Discount Price: $15,153
  • vs. Medicare Baseline: 1.21x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Presence Mercy Medical Center is $15,457. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15,153. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.21x the Medicare baseline. Located in 1325 N Highland Avenue, Aurora, IL.
Cash / Self-Pay
$15,153

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,457

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: $15,153 (118%)
Insurance Median: $15,457 (121%)
Cash: $15,153 (118% of Medicare)
Ins. Median: $15,457 (121% 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
Blue Cross Blue Shield $14,396 - $25,270 112%
Advocate Helath Partners $15,154 118%
Aetna $15,154 - $15,911 118%
Celtic (Wellcare) $15,154 118%
Cigna $15,154 - $15,171 118%
Devoted Health $15,154 118%
Harmony Health Plan $15,154 118%
Health Alliance Medical Plan $15,154 118%
Humana $15,154 - $16,669 118%
Longevity Health Plan Of Illinois $15,154 118%
Medicare (plans) $15,154 118%
Self-Pay $15,154 118%
United Behavioral Health $15,154 118%
UnitedHealthcare $15,154 118%
Clear Spring Health Of Illinois $15,305 120%
Molina $15,608 - $22,731 122%
Zing Health Provider Network $15,608 122%
Meridian $15,911 124%
Provider Partners Health Plan (Pphp) $15,911 124%
Access Community Health Network $18,185 142%
Tricare $23,392 183%
Clifton Health Systems $23,488 183%
Ambetter / Centene $24,549 192%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1325 N Highland Avenue, Aurora, IL 60506
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals