CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Sarah Bush Lincoln Health Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $71,525
  • Cash Discount Price: $90,538
  • vs. Medicare Baseline: 5.58x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Sarah Bush Lincoln Health Center is $71,525. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90,538. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 5.58x the Medicare baseline. Located in 1000 Health Center Drive P O Box 372, Mattoon, IL.
Cash / Self-Pay
$90,538

Average discount available for prompt cash payment at this facility.

Insurance Median
$71,525

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: $90,538 (707%)
Insurance Median: $71,525 (558%)
Cash: $90,538 (707% of Medicare)
Ins. Median: $71,525 (558% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 558% of the Medicare baseline (a markup of 458%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $13,771 - $83,295 108%
Bc Comm Mmai $13,771 108%
Beacon Health Options Behav-All Plans $13,771 108%
Hlth Alliance Mcr Adv $13,771 108%
Humana $13,771 - $14,046 108%
Meridian Mmai-All Other Plans $13,771 108%
Molina Mmai-All Other Plans $13,771 108%
Tricare $13,771 108%
UnitedHealthcare $13,771 - $75,147 108%
Va Ccn-All Plans $13,771 108%
Wellcare Med Adv-All Plans $13,771 108%
Bc Med Adv Ppo/Hmo $14,184 111%
Plain Church Mg-All Plans $36,215 283%
Mennonite-All Plans $40,742 318%
Eiu Athlete-All Other Plans $63,377 495%
Healthscope-All Plans $66,998 523%
Rural King-All Plans $66,998 523%
Blue Cross Blue Shield $71,525 - $72,430 558%
Consociate-All Plans $72,430 566%
Hope Trust-All Plans $72,430 566%
Eiu Student $74,241 580%
Allied National-All Plans $76,052 594%
Companion Life-All Plans $76,052 594%
Hlth Alliance-All Other Plans $76,052 594%
First Health-All Plans $76,957 601%
Innovative Hlthware-All Plans $76,957 601%
Healthlink Hmo $77,863 608%
Healthlink Ppo - All Other Plans $77,863 608%
Multiplan-All Plans $77,863 608%
Cigna $81,484 636%
Cphp-All Plans $81,484 636%
Beech Street-All Plans $83,295 650%
Hfn-All Plans $83,295 650%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Health Center Drive P O Box 372, Mattoon, IL 61938
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals