Heart stent placement (inpatient stay)
Facility: Providence Medical Center
Billing Code: 322 (MS-DRG)
- CPT Billing Code: 322
- Insurance Median: $14,011
- Cash Discount Price: $13,343
- vs. Medicare Baseline: 1.09x 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 |
|---|---|---|
| UnitedHealthcare | $9,124 - $19,000 | 71% |
| Medicaid / KanCare | $9,124 | 71% |
| Healthy Blue | $9,306 - $14,011 | 73% |
| Celtic | $9,306 - $18,014 | 73% |
| Aetna | $9,306 - $21,606 | 73% |
| Blue Cross Blue Shield | $12,958 - $20,668 | 101% |
| Midland Care Connection | $13,344 | 104% |
| Tricare | $13,344 - $21,071 | 104% |
| Cigna | $13,344 | 104% |
| Medicare (plans) | $13,344 | 104% |
| Kansas Superior Select | $14,011 | 109% |
| Corizon | $17,347 | 135% |
| Employer Direct Healthcare | $17,347 | 135% |
| Well Path Prison | $18,681 | 146% |
| Centurion | $20,015 | 156% |
| Naphcare | $20,682 | 161% |
Consumer Guidance & Cost Commentary
For the procedure "Heart stent placement (inpatient stay)" at Providence Medical Center in Kansas City, KS, the cash median price is $13,343. This rate is notably lower than the negotiated rates charged by most major payers, such as UnitedHealthcare, Aetna, and Blue Cross Blue Shield, which range from $9,124 to $21,606 depending on the specific plan. While Medicare sets a benchmark of $12,807.10 for this service, the facility's cash price is slightly higher at 1.1 times the Medicare amount. Patients with high-deductible plans or those seeking to minimize out-of-pocket costs should consider paying cash directly, as the self-pay rate avoids the administrative markups inherent in commercial insurance contracts. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payments can sometimes result in a lower total than the standard cash median.
When reviewing the billing statement, consumers should request a detailed itemized audit rather than accepting a summary bill, as over 80% of hospital invoices contain errors such as unbundled codes or services not rendered. Comparing the facility's pricing to the state average is essential; while specific county averages are not provided in this data, the facility's negotiated rates for many payers exceed the Medicare benchmark, which serves as the scientifically validated baseline for true healthcare costs. If a patient receives a bill that appears inflated, they should dispute any charges for items not rendered or codes that were bundled incorrectly, ensuring the final amount reflects the actual services provided. Understanding these billing principles helps patients avoid unexpected debt and ensures they