CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Presence Saints Mary and Elizabeth Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $16,701
Cash Discount Price: $17,086
vs. Medicare Baseline: 1.30x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Presence Saints Mary and Elizabeth Medical Center is $16,701. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17,086. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.30x the Medicare baseline. Located in 2233 W Division St, Chicago, IL.

Cash / Self-Pay

$17,086

Average discount available for prompt cash payment at this facility.

Insurance Median

$16,701

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: $17,086 (133%)

Insurance Median: $16,701 (130%)

Cash: $17,086 (133% of Medicare)

Ins. Median: $16,701 (130% 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	$15,110 - $24,909	118%
Cigna	$15,171 - $20,274	118%
Aetna	$15,906 - $16,701	124%
Celtic (Wellcare)	$15,906	124%
Devoted Health	$15,906	124%
Humana	$15,906 - $18,795	124%
Illini Care	$15,906	124%
Illinois Physicians Alliance	$15,906	124%
Longevity Health Plan Of Illinois	$15,906	124%
United Behavioral	$15,906	124%
UnitedHealthcare	$15,906 - $17,086	124%
Clear Spring Health Of Illinois	$16,065	125%
Molina	$16,383 - $25,630	128%
Zing Health Provider Network	$16,383	128%
Meridian	$16,701	130%
Provider Partners Health Plan (Pphp)	$16,701	130%
Medicare (plans)	$17,086	133%
Self Pay	$17,086	133%
Hfn Inc (Healthcare Finest Network)	$18,242	142%
Access Community Health Network	$20,504	160%
Tricare	$25,872	202%
Clifton Health Systems	$26,484	207%
Ambetter / Centene	$27,680	216%

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 $17,086.
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 Presence Saints Mary and Elizabeth 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.