Heart stent placement (inpatient stay)
Facility: Kansas Spine & Specialty Hospital, Llc
Billing Code: 322 (MS-DRG)
- CPT Billing Code: 322
- Insurance Median: $11,517
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.90x 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 | $1,401 - $11,517 | 11% |
| Humana | $11,286 | 88% |
| United Mine Workers Of America | $11,517 | 90% |
| Providrs Care Network | $11,517 - $15,579 | 90% |
| Aetna | $11,517 - $15,317 | 90% |
| Blue Cross Blue Shield | $11,517 | 90% |
| Lantern Specialty Care | $18,427 | 144% |
Consumer Guidance & Cost Commentary
For the procedure "Heart stent placement (inpatient stay)" at Kansas Spine & Specialty Hospital, Llc, the Medicare benchmark rate is $12,807.10. This federal baseline represents the scientifically validated cost of care, serving as the objective standard against which all commercial rates are measured. While the facility's median negotiated rate across payers is $11,517.00, this figure is lower than the Medicare amount, indicating a pricing structure that aligns with fair value rather than the typical 200% to 300% markup often seen in commercial billing. It is important to note that cash-pay options are not listed for this specific code, meaning patients without insurance coverage would need to inquire directly about self-pay or prompt-pay discounts, which can sometimes offer significant savings if the negotiated insurance rate exceeds the cash price.
Pricing for this service varies significantly depending on the insurance carrier, with allowed amounts ranging from $1,401 for UnitedHealthcare plans to $18,427 for Lantern Specialty Care. These negotiated rates reflect the contractual agreements between the hospital and specific insurers, which can differ widely even within the same state. Since the facility is located in Wichita, Kansas, and operates as an Acute Care Hospital, patients should verify their specific plan's allowed amount before scheduling, as in-network rates are not uniform across all providers. To ensure you are receiving the most accurate pricing, we recommend requesting an itemized bill to review every line item and confirming whether any balance billing protections apply to your specific situation.