Heart stent placement (inpatient stay)
Facility: Stormont Vail Hospital
Billing Code: 322 (MS-DRG)
- CPT Billing Code: 322
- Insurance Median: $12,941
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.01x 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 |
|---|---|---|
| Ambetter / Centene | $8,395 - $16,549 | 66% |
| UnitedHealthcare | $8,395 - $16,549 | 66% |
| Blue Cross Blue Shield | $8,477 - $48,343 | 66% |
| Aetna | $11,539 - $12,941 | 90% |
| Humana | $11,539 - $12,941 | 90% |
Consumer Guidance & Cost Commentary
For the Heart stent placement (inpatient stay) procedure at Stormont Vail Hospital in Topeka, KS, the negotiated rates for in-network insurance plans range from $8,395 to $48,343, with a median negotiated amount of $12,941. This commercial rate is slightly higher than the Medicare benchmark of $12,807.10, reflecting the administrative costs and contract structures inherent in private insurance billing. While the facility offers a 4-star rating, patients should be aware that cash-pay options are not listed in this report; however, it is often financially advantageous for individuals with high-deductible plans to inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can significantly reduce the final cost compared to the insurance negotiated rate.
Because commercial insurance rates are often inflated by multi-layered administrative structures, relying solely on the insurance allowed amount can lead to higher out-of-pocket expenses than paying cash upfront. The No Surprises Act provides federal protections against balance billing for out-of-network providers at in-network facilities, but patients must still verify their specific plan details and deductible status before scheduling. To ensure accuracy and avoid unexpected charges, consumers should request a full itemized CPT-coded bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Disputing these errors via certified mail to the billing supervisor is the most effective method to reduce medical debt and secure the true cost of care.