CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Wilson Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $13,208
  • Cash Discount Price: $47,135
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Wilson Medical Center is $13,208. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47,135. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.03x the Medicare baseline. Located in 1705 S Tarboro St, Wilson, NC.
Cash / Self-Pay
$47,135

Average discount available for prompt cash payment at this facility.

Insurance Median
$13,208

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: $47,135 (368%)
Insurance Median: $13,208 (103%)
Cash: $47,135 (368% of Medicare)
Ins. Median: $13,208 (103% 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
Aetna $13,208 103%
Blue Cross Blue Shield $13,208 - $16,194 103%
Humana $13,208 103%
Medicare (plans) $13,208 103%
Pyramid $13,208 103%
Unicare $13,208 103%
Wellcare $13,208 103%
Devoted Health $13,340 104%
UnitedHealthcare $13,340 104%
Amerihealth Caritas Health Plan $16,423 128%
Tricare $21,317 166%
Cigna $24,978 195%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1705 S Tarboro St, Wilson, NC 27893
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals