Heart stent placement (inpatient stay)
Facility: Mercy Hospital Pittsburg, Inc
Billing Code: 322 (MS-DRG)
- CPT Billing Code: 322
- Insurance Median: $14,924
- Cash Discount Price: $39,026
- vs. Medicare Baseline: 1.17x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
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 | $8,227 - $24,101 | 64% |
| Medicaid / KanCare | $8,227 - $15,214 | 64% |
| Humana | $11,553 - $14,924 | 90% |
| Aetna | $11,553 - $15,037 | 90% |
| Providrs Care Network Contracted [320484] | $13,751 | 107% |
| Medica Contracted [320239] | $14,788 | 115% |
| Medicare (plans) | $14,924 - $14,967 | 117% |
| Dept Of Veteran Affairs Contracted [320106] | $14,924 | 117% |
| Kindful Hospice [20434] | $14,924 | 117% |
| Mercy Hospice Okc [20252] | $14,924 | 117% |
| Indian Health Service Contracted [320198] | $14,924 | 117% |
| Pace Of The Ozarks Contracted [320518] | $14,924 | 117% |
| Elara Caring Aspire Hospice [20433] | $14,924 | 117% |
| Halo Hcr Inc Hospice [20432] | $14,924 | 117% |
| Cross Timbers Hospice [20098] | $14,924 | 117% |
| Halo Hcr Inc Hospice Contracted [320432] | $14,924 | 117% |
| Kindful Hospice Contracted [320434] | $14,924 | 117% |
| American Health Advantage Of Ks Mcr Contracted [320508] | $14,924 | 117% |
| Home State Health Plan Contracted [320187] | $15,214 | 119% |
| Ambetter / Centene | $15,214 | 119% |
| UnitedHealthcare | $15,214 | 119% |
| Cigna | $18,060 - $20,999 | 141% |
| Tricare | $21,042 | 164% |
| Health Choice Contracted [320166] | $22,796 | 178% |
Consumer Guidance & Cost Commentary
For the procedure of heart stent placement at Mercy Hospital Pittsburg, Inc, the facility's cash median rate is $39,026, which is significantly higher than the state average of $26,280. While commercial insurance plans like Blue Cross Blue Shield and Medicaid/KanCare negotiate rates ranging from $8,227 to $24,101, these figures often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket and seeking prompt-pay discounts. It is important to note that while the facility is a voluntary non-profit church-owned hospital, commercial payers may still apply administrative markups that inflate their negotiated rates above the direct cash cost, so verifying the specific "self-pay" or "prompt-pay" discount available before scheduling is essential for minimizing out-of-pocket expenses.
The facility's Medicare benchmark rate of $12,807.10 serves as a critical baseline for evaluating pricing fairness, as commercial negotiated rates frequently range between 200% and 300% of this federal standard. Although the data shows a "vs_medicare" multiplier of 1.2 for the cash rate, patients should remain vigilant regarding balance billing risks, particularly if receiving care from out-of-network ancillary services like emergency physicians or labs, which could trigger unexpected bills despite the No Surprises Act protections for in-network facilities. To ensure accuracy and avoid overcharging, consumers are encouraged to request a full itemized billing audit rather than accepting summary invoices, as detailed line-by-line reviews can identify unbundled codes or services not rendered, effectively reducing the total debt owed.