CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Saint Joseph Hospital-Elgin

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $15,200
Cash Discount Price: $14,757
vs. Medicare Baseline: 1.19x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Saint Joseph Hospital-Elgin is $15,200. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14,757. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.19x the Medicare baseline. Located in 77 N Airlite Street, Elgin, IL.

Cash / Self-Pay

$14,757

Average discount available for prompt cash payment at this facility.

Insurance Median

$15,200

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: $14,757 (115%)

Insurance Median: $15,200 (119%)

Cash: $14,757 (115% of Medicare)

Ins. Median: $15,200 (119% 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	$14,019 - $23,901	109%
Aetna	$14,757 - $15,495	115%
Celtic (Wellcare)	$14,757	115%
Cigna	$14,757 - $15,171	115%
Devoted Health	$14,757	115%
Harmony Health Plan	$14,757	115%
Humana	$14,757 - $16,233	115%
Longevity Health Plan Of Illinois	$14,757	115%
Medicare (plans)	$14,757	115%
Self-Pay	$14,757	115%
United Behavioral	$14,757	115%
UnitedHealthcare	$14,757	115%
Clear Spring Health Of Illinois	$14,905	116%
Molina	$15,200 - $22,136	119%
Zing Health Provider Network	$15,200	119%
Meridian	$15,495	121%
Providers Partners Health Plan (Pphp)	$15,495	121%
Access Community Health Network	$17,709	138%
Imagine Health Network, Inc	$20,356	159%
Clifton Health Systems	$22,874	179%
Tricare	$23,110	180%
Ambetter / Centene	$23,907	187%

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 $14,757.
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 Saint Joseph Hospital-Elgin 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.