Heart stent placement (inpatient stay)
Facility: Bob Wilson Memorial Hospital
Billing Code: 322 (MS-DRG)
- CPT Billing Code: 322
- Insurance Median: $25,585
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 2.00x 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 |
|---|---|---|
| Blue Cross Blue Shield | $25,585 | 200% |
Consumer Guidance & Cost Commentary
For the Heart stent placement procedure at Bob Wilson Memorial Hospital in Ulysses, Kansas, the facility's negotiated rate is $25,585, which matches the lowest and highest reported figures for this service in the area. This rate is significantly higher than the Medicare benchmark of $12,807.10, reflecting a markup of 200% over the federal baseline. While the facility is a Critical Access Hospital owned by a voluntary non-profit church, patients should be aware that commercial insurance contracts often include administrative overheads that inflate the final price. Because the negotiated rate exceeds the cash price, individuals with high-deductible plans might find it financially advantageous to pay out-of-pocket if the facility offers a self-pay or prompt-pay discount, potentially bypassing the higher insurance negotiated ceiling.
Before scheduling, it is crucial to verify whether the facility can classify the service as self-pay to access potential prompt-pay discounts, which can range from 20% to 50% off the total bill. Patients should avoid waiting until after receiving a post-insurance bill to inquire about cash rates, as billing systems may automatically submit claims to insurance carriers, voiding any upfront payment agreements. Additionally, since the No Surprises Act prohibits balance billing for emergency care and non-emergency services at in-network facilities, patients should review their itemized bill carefully to ensure no unexpected charges from out-of-network ancillary services appear. Requesting a full, line-by-line itemized statement before payment is the most effective way to identify errors, unbundled codes, or services not rendered, ensuring the final amount aligns with the negotiated or self-pay rates disclosed.