CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: SSM Health Saint Louis University Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $20,274
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.58x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at SSM Health Saint Louis University Hospital is $20,274. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.58x the Medicare baseline. Located in 1201 S Grand Blvd, Saint Louis, MO.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$20,274

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%)

Insurance Median: $20,274 (158%)

Ins. Median: $20,274 (158% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Medica	$15,895 - $20,274	124%
Blue Cross Blue Shield	$19,868	155%
Aetna	$20,274 - $20,679	158%
Ambetter / Centene	$20,274 - $21,244	158%
Gateway To Better Health	$20,274	158%
Health Alliance	$20,274	158%
Icare	$20,274	158%
Mercy	$20,274	158%
Molina Healthcare	$20,274	158%
New Horizons Pace	$20,274	158%
UnitedHealthcare	$20,274 - $33,499	158%
Humana	$20,618	161%
Essence	$20,882	163%
Cigna	$23,471	183%
Healthlink	$35,762 - $78,365	279%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 322.

Insurance In-Network Protection Plan

Contact your insurance company to confirm SSM Health Saint Louis University Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 322.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.