Heart stent placement (inpatient stay)
Facility: Saint Luke'S South Hospital
Billing Code: 322 (MS-DRG)
- CPT Billing Code: 322
- Insurance Median: $24,912
- Cash Discount Price: $73,097
- vs. Medicare Baseline: 1.95x 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 |
|---|---|---|
| Humana | $3,100 - $23,974 | 24% |
| Cigna | $3,300 - $26,177 | 26% |
| Transplants-Case Rates [5750] | $4,300 - $83,173 | 34% |
| Blue Cross Blue Shield | $5,480 - $54,917 | 43% |
| Medicaid / KanCare | $9,138 - $10,052 | 71% |
| Medicare (plans) | $11,834 - $12,426 | 92% |
| UnitedHealthcare | $17,362 - $28,594 | 136% |
| Commercial-Contracted [8000] | $18,744 - $18,935 | 146% |
| Aetna | $27,575 - $54,692 | 215% |
Consumer Guidance & Cost Commentary
Saint Luke's South Hospital lists a cash median price of $73,097 for Heart stent placement (inpatient stay). This rate is significantly lower than the facility's gross charge of $121,828, reflecting the discount structure available for self-pay patients. For those with high-deductible plans or limited insurance coverage, paying the cash price may be more cost-effective than relying on insurance, as commercial negotiated rates often exceed the cash price due to administrative overhead and contract dynamics. Patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling to ensure they are receiving the lowest possible rate.
While the cash rate is competitive relative to the facility's own billing, commercial insurance contracts can result in higher out-of-pocket costs depending on the plan. For example, Cigna's high-end negotiated rate is $26,177, and UnitedHealthcare's high-end rate is $28,594, which are substantially lower than the cash price but may still exceed a patient's deductible or copay obligations. It is important to note that Medicare allows a payment of $12,807.10 for this procedure, serving as a baseline for evaluating the markup of commercial rates. Consumers are advised to request an itemized bill and confirm their specific plan's allowed amount to avoid unexpected balance billing, though federal protections generally shield patients from surprise charges at in-network facilities.