CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Trinity Health Oakland Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $26,293
  • Cash Discount Price: $46,410
  • vs. Medicare Baseline: 2.05x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Trinity Health Oakland Hospital is $26,293. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46,410. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 2.05x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.
Cash / Self-Pay
$46,410

Average discount available for prompt cash payment at this facility.

Insurance Median
$26,293

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: $46,410 (362%)
Insurance Median: $26,293 (205%)
Cash: $46,410 (362% of Medicare)
Ins. Median: $26,293 (205% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 205% of the Medicare baseline (a markup of 105%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Health Cost Solutions $2,000 16%
Vitalcore $2,000 16%
Wellpath $2,000 16%
Aetna $12,964 - $26,293 101%
Blue Care Network Advantage $12,964 101%
Blue Cross Blue Shield $12,964 - $42,015 101%
Medicare (plans) $12,964 - $13,228 101%
Align Senior Care $13,228 103%
UnitedHealthcare $13,625 106%
Cca - Zing Health $14,001 109%
Longevity Ipa Of Michigan Llc Health Plan Isnp $14,908 116%
Employee Benefit Logistic $15,691 123%
Molina Marketplace $17,197 134%
U Of M Health Plan $24,823 194%
Priority Health $25,812 - $28,680 202%
Geha $26,293 205%
Medical Mutual $26,293 205%
Meritain $26,293 205%
Asr Health Benefits $28,848 225%
Caresource $28,848 225%
Hap $28,848 225%
Varipro $28,848 225%
Bcn Domestic $42,015 328%
Blue Benefit Administrators Of Massachusetts $42,015 328%
Blue Care Network $42,015 328%
Blue Distinction Transplant $42,015 328%
Blue Shield - Ca $42,015 328%
Blue Shield - Id (Regence) $42,015 328%
Blue Shield - Ny Highmark Northeastern $42,015 328%
Blue Shield - Ny Highmark Western $42,015 328%
Blue Shield - Pa (Highmark) $42,015 328%
Blue Shield - Wa (Regence) $42,015 328%
Health Choices $42,015 328%
Kaiser Domestic $42,015 328%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 44405 Woodward Ave, Pontiac, MI 48341
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals