CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: The Women's Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $20,999
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.64x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at The Women's Hospital is $20,999. 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 1.64x the Medicare baseline. Located in 4199 Gateway Blvd, Newburgh, IN.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$20,999

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: $20,999 (164%)

Ins. Median: $20,999 (164% 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
Amish	$8,400	66%
Aetna	$14,031 - $18,357	110%
Humana	$14,031 - $20,999	110%
Passport Molina Ky	$14,031	110%
UnitedHealthcare	$14,031 - $29,157	110%
Wellcare Ky	$14,031 - $20,999	110%
Blue Cross Blue Shield	$20,999 - $29,461	164%
Caresource	$20,999	164%
Immergrun	$20,999	164%
Iu Health	$20,999	164%
Meridian Health Il	$20,999	164%
Mhs	$20,999	164%
Molina Il	$20,999	164%
Molina Ky	$20,999	164%
Molina Ky Dual	$20,999	164%
Alliance Coal	$21,966	172%
Encoreprime	$28,088	219%
Claritev (Formerly Phcs/Mulitplan)	$29,164	228%
Claimdoc	$30,449	238%
One Care	$30,796	240%
Chamber Care	$30,896	241%
Caresource Marketplace (Just4Me)	$31,499	246%
Hst	$31,499	246%
Cigna	$32,971	257%
Sagamore	$32,971	257%
Ambetter / Centene	$33,599	262%
Noncontracted	$33,599	262%
Hope Trust	$34,649	271%
Allied National/Zelis - Freedom Plan	$51,448	402%

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 The Women's Hospital 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.