CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Melrosewakefield Healthcare

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $15,596
  • Cash Discount Price: $34,850
  • vs. Medicare Baseline: 1.22x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Melrosewakefield Healthcare is $15,596. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $34,850. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.22x the Medicare baseline. Located in 585 Lebanon Street, Melrose, MA.
Cash / Self-Pay
$34,850

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,596

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: $34,850 (272%)
Insurance Median: $15,596 (122%)
Cash: $34,850 (272% of Medicare)
Ins. Median: $15,596 (122% 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
Elementcare [450046] $3,105 24%
Meritain [100063] $4,127 32%
Fallon Senior [450065] $14,443 - $15,426 113%
Champva [800006] $15,426 120%
Cigna $15,426 120%
Harvard Pilgrim Stride [450060] $15,426 120%
Humana $15,426 120%
Martins Point Generations Replacement [450057] $15,426 120%
Medicaid / KanCare $15,426 - $27,679 120%
Medicare (plans) $15,426 - $15,725 120%
Neighborhood Pace [450114] $15,426 120%
Peak Pace Solutions [450115] $15,426 120%
Secure Horizons Ma Pffs [450077] $15,426 120%
UnitedHealthcare $15,426 - $15,596 120%
Veterans Evaluation Svcs [800004] $15,426 120%
Veterans Services [800005] $15,426 120%
Blue Cross Blue Shield $15,596 - $44,041 122%
Commonwealth Care Alliance [450067] $15,596 122%
Wellpoint [100139] $18,785 147%
Fallon Health Connectorcare [100260] $22,330 174%
Fallon Health [100259] $22,330 174%
Tufts Health Public Plan Connectorcare [100264] $25,998 203%
Generic Prison [500099] $26,361 206%
Middlesex County [500015] $26,361 206%
Suffolk County [500014] $26,361 206%
Tewksbury Hospital [950008] $26,361 206%
Tufts Health Public Plan [350009] $26,361 206%
Wellsense Nh [350010] $26,361 206%
Wellsense Clarity Connectorcare [100256] $39,383 - $44,814 308%
Blue Benefits Administrators [100267] $40,561 - $44,041 317%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 585 Lebanon Street, Melrose, MA 02176
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals