CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Community Medical Center

Billing Code: 322 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$21,591

about 1.7× the $12,807 Medicare rate · typically $15,951–$34,832

modeled estimate · not a bill or quote

What this hospital charges insurers

$33,906

Above the fair price

about $12,315 over the fair price · 2.6× Medicare

Medicare pays $12,807 Fair price $21,591 This hospital $33,906 Cash price $2,426

How we calculate the fair BaseRate →

How this hospital compares to other NJ hospitals

Highest price of the 9 NJ hospitals we have prices for — worth calling around.

Cheapest $14,255 Priciest $33,906

Black dot = this hospital, among the 9 NJ hospitals with a price for this procedure. Full list below.

A fair price for a Heart stent placement (inpatient stay) is about $21,591 (about 1.7× the $12,807 Medicare rate). Community Medical Center charges insurers about $33,906, or about $2,426 in cash — above the fair price. Located in Toms River, NJ.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $21,591. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$16,121 - $48,286	126%
Blue Cross Blue Shieldmajor	$1,885 - $48,229	15%
Aetnamajor	$15,805 - $43,609	123%
Cignamajor	$32,908 - $44,041	257%
Humanamajor	$15,805	123%
Clover Health	$15,805	123%
Fidelis Care	$15,805	123%
WellCare	$31,452	246%
+ 1 smaller / regional plan	$24,934

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 2,426), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 322.

Insurance Before you use insurance

Call your insurance company to confirm Community Medical Center is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 322.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Community Medical Center

Compare: Heart stent placement (inpatient stay) at other NJ hospitals

Valley Hospital · Paramus $14,255
Cape Regional Medical Center Inc · Cape May Court House $14,518
Shore Medical Center · Somers Point $14,609
Carewell Health Medical Center · East Orange $15,632
Southern Ocean Medical Center · Manahawkin $15,685
Riverview Medical Center · Red Bank $15,719
Bayshore Medical Center · Holmdel $15,825
St Luke's Warren Hospital · Phillipsburg $16,991

Insurance negotiated median for the same procedure, sorted lowest first.