Heart stent placement (inpatient stay)
Facility: Children'S Mercy South
Billing Code: 322 (MS-DRG)
- CPT Billing Code: 322
- Insurance Median: $10,995
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.86x 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 | $10,308 | 80% |
| Healthy Blue | $10,995 | 86% |
| Medicaid / KanCare | $11,486 | 90% |
Consumer Guidance & Cost Commentary
For the Heart stent placement procedure at Children's Mercy South in Overland Park, KS, the negotiated rates for UnitedHealthcare, Healthy Blue, and Medicaid/KanCare range from $10,308 to $11,486. These commercial rates are significantly higher than the Medicare benchmark of $12,807.10, which serves as the federal baseline for the true cost of care. While commercial contracts often include administrative overhead that can inflate prices by 20% to 40%, the data indicates that the facility's negotiated rates are actually lower than the Medicare amount for this specific service. This suggests that for patients with high-deductible plans, paying the cash price or utilizing a prompt-pay discount may result in lower out-of-pocket costs compared to the insurance negotiated ceiling, provided the patient's plan allows for such flexibility.
It is important to note that the facility does not publish a specific cash median or negotiated median in the current dataset, so patients should directly contact the billing department to confirm self-pay or prompt-pay discounts before scheduling. Under the No Surprises Act, patients are protected from balance billing for out-of-network services at in-network facilities, but they must ensure their plan covers the service and that no unexpected ancillary charges apply. To maximize savings, patients should request a full itemized bill to verify that all charges align with the negotiated rate and that no unbundled codes or services not rendered have been included. Always verify your deductible status prior to treatment, as paying the full negotiated rate without meeting your deductible can lead to higher financial exposure than anticipated.