Heart stent placement (inpatient stay)
Facility: Wesley Medical Center
Billing Code: 322 (MS-DRG)
- CPT Billing Code: 322
- Insurance Median: $14,308
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.12x 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 |
|---|---|---|
| Usa Managed Care | $1,800 | 14% |
| First Health | $2,038 - $22,968 | 16% |
| Aetna | $2,038 - $22,968 | 16% |
| United | $3,721 - $23,890 | 29% |
| UnitedHealthcare | $9,138 | 71% |
| Amerigroup | $9,503 | 74% |
| Medicaid / KanCare | $10,710 | 84% |
| Wppa | $13,610 - $19,442 | 106% |
| Coventry Health Care | $14,308 | 112% |
| Humana | $14,308 | 112% |
| Devoted Health | $14,594 | 114% |
| Ambetter / Centene | $14,737 - $16,849 | 115% |
| Blue Cross Blue Shield | $21,107 | 165% |
| Correct Care Solutions | $21,462 | 168% |
Consumer Guidance & Cost Commentary
For the procedure of heart stent placement at Wesley Medical Center in Wichita, KS, the negotiated rates paid by insurance plans range from $1,800 to $23,890, with a median negotiated amount of $14,308. While the facility's median negotiated rate is $14,308, the Medicare benchmark for this service is $12,807.10, indicating that commercial contracts are priced at approximately 110% of the Medicare baseline. It is important to note that cash-pay rates are not available for this specific code, meaning patients without insurance coverage cannot utilize potential cash discounts. In cases where cash prices are lower than insurance negotiated rates, patients with high-deductible plans may benefit from paying out-of-pocket, but this option is not applicable here as the cash median is null.
Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, unexpected charges can still arise from ancillary services or if a patient inadvertently accepts a summary bill instead of an itemized statement. To ensure transparency, consumers should request a detailed, line-by-line itemized bill to verify that all charges correspond to services actually rendered and to identify any potential code unbundling or errors. Additionally, since prompt-pay discounts are not listed for this service, patients should directly contact the hospital billing department to inquire about any self-pay or prompt-pay incentives that may apply to their specific situation, as these discounts can significantly reduce the final amount owed.