CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Northwest Health - Porter

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $17,362
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.36x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Northwest Health - Porter is $17,362. 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 1.36x the Medicare baseline. Located in 85 East Us Hwy 6, Valparaiso, IN.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$17,362

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: $17,362 (136%)

Ins. Median: $17,362 (136% 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
UnitedHealthcare	$12,175 - $20,837	95%
Humana	$13,444	105%
Aetna	$13,524	106%
Blue Cross Blue Shield	$13,524 - $22,565	106%
Medicare (plans)	$13,524 - $14,777	106%
Node Mhs Mcr Adv	$13,524	106%
Healthy Indiana Plan	$13,764	107%
Care Improvement Plus	$14,200	111%
In Dept Of Correction	$14,315	112%
Node Devoted Health Mcr Adv	$15,072	118%
Node Va	$15,344	120%
Encore Health	$17,584	137%
Encore Ppo	$17,584	137%
Node Us Dept Of Labor	$21,734	170%
First Health Coventry	$22,951	179%
Preferred Network Access	$24,776	193%
Prime Health	$24,776	193%
Indiana Work Comp	$27,529	215%
Lutheran Preferred	$27,529	215%
Managed Health Services	$30,087	235%
Porter County	$33,034	258%
Node Encore Kba Epo	$36,104	282%
Magnacare Ma	$38,314	299%

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 Northwest Health - Porter 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.