Heart stent placement (inpatient stay)
Facility: Kansas City Orthopaedic Institute
Billing Code: 322 (MS-DRG)
- CPT Billing Code: 322
- Insurance Median: $13,511
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.05x 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 |
|---|---|---|
| Cigna | $12,114 - $15,751 | 95% |
| Aetna | $12,114 | 95% |
| UnitedHealthcare | $12,114 - $17,291 | 95% |
| Blue Cross Blue Shield | $12,234 - $20,679 | 96% |
| Medica | $18,152 | 142% |
Consumer Guidance & Cost Commentary
For the procedure "Heart stent placement (inpatient stay)" at Kansas City Orthopaedic Institute in Leawood, KS, the facility's negotiated rates range from $12,114 to $20,679 across five major payers, with a median negotiated amount of $13,511. This commercial rate is 11% higher than the Medicare benchmark of $12,807.10, which serves as the objective baseline for fair pricing. While cash prices are not listed for this specific code, patients with high-deductible plans should be aware that paying cash upfront can sometimes be more cost-effective if the insurance negotiated rate exceeds the cash price. It is crucial to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can significantly reduce the final bill by bypassing administrative fees and claims processing costs.
Patients should exercise caution regarding balance billing and billing errors, as over 80% of hospital bills contain mistakes such as unbundled codes or services not rendered. Even though the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, patients must ensure they are not signing away these rights via consent waivers for emergency or mandatory ancillary services. If a large bill arrives, do not pay immediately; instead, request a full itemized CPT-coded statement to identify any errors before negotiating. Disputing charges via certified mail to the billing supervisor is the most effective way to resolve issues, ensuring that the final amount reflects the true cost of care rather than inflated chargemaster lists or administrative markups.