CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Ocean Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $17,971
Cash Discount Price: $15,364
vs. Medicare Baseline: 1.40x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Ocean Medical Center is $17,971. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15,364. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.40x the Medicare baseline. Located in 425 Jack Martin Blvd, Brick, NJ.

Cash / Self-Pay

$15,364

Average discount available for prompt cash payment at this facility.

Insurance Median

$17,971

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: $15,364 (120%)

Insurance Median: $17,971 (140%)

Cash: $15,364 (120% of Medicare)

Ins. Median: $17,971 (140% 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
Vaccn	$14,933 - $15,795	117%
Horizon	$15,110 - $16,430	118%
Aetna	$16,430 - $50,468	128%
Amerigroup	$16,430 - $16,487	128%
Wellcare	$16,430 - $16,487	128%
Blue Cross Blue Shield	$16,487	129%
United Community/Americhoice	$17,251 - $17,311	135%
Clover	$18,136	142%
Seoul Medical Group	$18,402 - $18,465	144%
UnitedHealthcare	$19,784 - $69,294	154%
Karna	$23,583 - $23,659	184%
Cigna	$51,414 - $60,780	401%
Oxford	$57,987	453%

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 $15,364.
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 Ocean Medical Center 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.