Heart stent placement (inpatient stay)
Facility: Wamego Health Center
Billing Code: 322 (MS-DRG)
- CPT Billing Code: 322
- Insurance Median: $9,391
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.73x 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 | $9,030 | 71% |
| Aetna | $9,391 | 73% |
| Medicaid / KanCare | $9,391 - $9,481 | 73% |
| Blue Cross Blue Shield | $25,772 - $27,128 | 201% |
Consumer Guidance & Cost Commentary
For the Heart stent placement (inpatient stay) procedure at Wamego Health Center in Wamego, KS, the facility's negotiated rates range from $9,030 to $27,128 depending on the payer. While Medicaid / KanCare plans show a range of $9,391 to $9,481, Blue Cross Blue Shield plans have significantly higher negotiated rates between $25,772 and $27,128. It is important to note that cash payments can sometimes be cheaper for patients with high-deductible plans if the insurance negotiated rate exceeds the cash price, though cash median data is not available for this specific code. Patients should always verify "self-pay" or "prompt-pay" discounts directly with the hospital before scheduling, as these upfront payment incentives can reduce the final cost by bypassing administrative fees and claims processing delays.
The facility's pricing is benchmarked against Medicare, which sets a fixed reimbursement rate of $12,807.10 for this service. The data indicates a ratio of 0.7 versus Medicare, suggesting the negotiated rates are below the Medicare benchmark for this specific vintage. However, because commercial insurance contracts often include administrative overhead and multi-layered pricing structures, the actual cost to the patient depends heavily on their specific plan's deductible and out-of-pocket maximums. To avoid unexpected balance billing, patients should request an itemized billing audit if they receive a summary bill, ensuring no unbundled codes or services not rendered are included, and should dispute any surprise charges related to out-of-network ancillary services under the No Surprises Act.