CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Baptist Health Lexington

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $20,639
  • Cash Discount Price: $138,039
  • vs. Medicare Baseline: 1.61x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Baptist Health Lexington is $20,639. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $138,039. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.61x the Medicare baseline. Located in 1740 Nicholasville Road, Lexington, KY.
Cash / Self-Pay
$138,039

Average discount available for prompt cash payment at this facility.

Insurance Median
$20,639

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$12,807.1

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $12,807.1 (100%)
Cash / Self-Pay: $138,039 (1078%)
Insurance Median: $20,639 (161%)
Cash: $138,039 (1078% of Medicare)
Ins. Median: $20,639 (161% of 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Wellcare Mcaid $9,732 - $14,574 76%
Aetna $10,515 - $66,737 82%
UnitedHealthcare $10,627 - $22,760 83%
Blue Cross Blue Shield $11,186 - $182,837 87%
Humana $11,186 - $45,838 87%
Medicaid / KanCare $11,186 87%
Molina Mcaid - All Plans $11,186 - $11,659 87%
Sig Advantage - All Plans $11,859 93%
Wellcare Mcr Adv - All Other Plans $11,859 - $12,630 93%
Wellmark Mcr Adv - All Plans $11,859 - $12,630 93%
Wellcare Med Adv - All Other Plans $12,311 96%
Signature Adv - All Plans $12,630 99%
Caresource Mcr Adv $13,437 105%
Siho Exclusive Ntwrk $15,338 120%
Siho Dual Ntwrk $16,748 - $21,156 131%
Cigna $17,616 - $21,939 138%
Siho Exclus Ntwrk $17,630 138%
Ambetter / Centene $20,155 157%
Caresource Just4Me - All Other Plans $20,155 157%
Caresource-All Plans $21,347 - $25,104 167%
Healthlink-All Plans $21,628 - $21,854 169%
Siho Ppo - All Other Plans $24,682 193%
Siho-All Plans $24,682 - $151,655 193%
Center Care - All Plans $27,586 215%
Mhs Mcaid - All Plans $51,186 400%
Center Care-All Plans $52,473 - $163,419 410%
Encore Preferred $91,354 713%
Multiplan/Phcs-All Plans $98,195 767%
Multiplan-All Plans $123,220 - $155,411 962%
Phcs-All Plans $130,075 - $152,728 1016%
Encore Ppo - All Other Plans $155,393 1213%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1740 Nicholasville Road, Lexington, KY 40503
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals