CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: The McDowell Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $16,243
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.27x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at The McDowell Hospital is $16,243. 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 1.27x the Medicare baseline. Located in 430 Rankin Drive P O Box 730, Marion, NC.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$16,243

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: $16,243 (127%)
Ins. Median: $16,243 (127% 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
United $15,350 - $15,396 120%
Aetna $15,704 123%
Alignment Health $15,704 123%
Devoted Health $15,704 123%
Humana $15,858 - $16,012 124%
Wellcare $15,858 - $20,384 124%
Cigna $16,012 125%
Healthteam Advantage $16,166 126%
Provider Partners Health Plan $16,166 126%
Troy Healthcare $16,166 126%
Apex Health $16,320 127%
Longevity Health Plan $16,474 129%
Nhc Advantage $16,474 129%
Amerihealth Caritas $17,551 - $30,029 137%
Blue Cross Blue Shield $19,790 155%
Vaya Health $20,384 159%
Amerihealth $20,582 161%
Partners Health Management $20,780 162%
Ambetter / Centene $29,996 234%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 430 Rankin Drive P O Box 730, Marion, NC 28752
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals