CMS Price Transparency Data
Heart stent placement (inpatient stay)
Facility: Mercy Hospital Springfield
Billing Code: 322 (MS-DRG)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 322
- Insurance Median: $14,597
- Cash Discount Price: $61,627
- vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Mercy Hospital Springfield is $14,597. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $61,627. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.14x the Medicare baseline. Located in 2115 S. Fremont Ave, Springfield, MO.
Cash / Self-Pay
$61,627
Average discount available for prompt cash payment at this facility.
Insurance Median
$14,597
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: $61,627 (481%)
Insurance Median: $14,597 (114%)
Cash: $61,627 (481% of Medicare)
Ins. Median: $14,597 (114% 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Ambetter / Centene | $3,891 | 30% |
| Home State Health Plan Contracted [320187] | $3,891 | 30% |
| Medicaid / KanCare | $3,891 - $9,631 | 30% |
| Novasys Contracted [320285] | $3,891 | 30% |
| Blue Cross Blue Shield | $8,227 - $18,175 | 64% |
| Aetna | $9,631 - $19,150 | 75% |
| Humana | $9,631 - $14,597 | 75% |
| Point C Contracted [320238] | $12,586 - $15,750 | 98% |
| Evolutions Health Care Contracted [320124] | $13,161 | 103% |
| Providrs Care Network Contracted [320484] | $13,751 | 107% |
| UnitedHealthcare | $14,320 - $25,154 | 112% |
| Federal Medical Center Contracted [320127] | $14,461 | 113% |
| Centivo Contracted [320505] | $14,597 | 114% |
| Centurion Of Missouri [20459] | $14,597 | 114% |
| Champva [20065] | $14,597 | 114% |
| Cherokee Nation Health Serv Contracted [320066] | $14,597 | 114% |
| Cigna | $14,597 - $20,999 | 114% |
| Cross Timbers Hospice [20098] | $14,597 | 114% |
| Dept Of Veteran Affairs Contracted [320106] | $14,597 | 114% |
| Elara Caring Aspire Hospice [20433] | $14,597 | 114% |
| Globalhealth Contracted [320145] | $14,597 | 114% |
| Halo Hcr Inc Hospice Contracted [320432] | $14,597 | 114% |
| Halo Hcr Inc Hospice [20432] | $14,597 | 114% |
| Indian Health Service Contracted [320198] | $14,597 | 114% |
| Indian Health Service [20198] | $14,597 | 114% |
| Kindful Hospice Contracted [320434] | $14,597 | 114% |
| Kindful Hospice [20434] | $14,597 | 114% |
| Medicare (plans) | $14,597 - $15,050 | 114% |
| Mercy Hospice Okc [20252] | $14,597 | 114% |
| Mercy Mgd Behavioral Health Contracted [320259] | $14,597 | 114% |
| Mercy Rehab Hospital Contracted [320260] | $14,597 | 114% |
| Pace Of The Ozarks Contracted [320518] | $14,597 | 114% |
| Qual Choice Contracted [320325] | $14,597 | 114% |
| Mercy Benefit Admin Contracted [320251] | $15,145 - $15,507 | 118% |
| Benefit Management Contracted [320052] | $15,179 | 119% |
| 90 Degree Benefits Contracted [320436] | $15,507 | 121% |
| Show-Me Health Administrators Contracted [320483] | $15,507 - $16,283 | 121% |
| Health Systems Inc Contracted [320174] | $15,634 | 122% |
| Insurance System Inc Contracted [320465] | $15,634 | 122% |
| Point C [20238] | $15,750 | 123% |
| Provider Partners Health Plans Contracted [320450] | $15,780 | 123% |
| Medica Contracted [320239] | $16,130 | 126% |
| Medica [20239] | $16,130 | 126% |
| Multiplan Contracted [320270] | $16,808 | 131% |
| Private Health Care Systems Contracted [320320] | $16,808 | 131% |
| Healthlink Contracted [320179] | $17,355 - $19,090 | 136% |
| Healthscope Contracted [320182] | $17,969 | 140% |
| United Medical Resources Contracted [320454] | $18,635 | 146% |
| Tricare | $21,042 | 164% |