CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Kaleida Health

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $20,547
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.60x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Kaleida Health is $20,547. 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 1.60x the Medicare baseline. Located in 100 High Street, Buffalo, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$20,547

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: $20,547 (160%)
Ins. Median: $20,547 (160% 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
Tricare $19,520 152%
Independent Health Association $19,849 - $20,547 155%
Independent Health Association - Wchob $19,849 155%
Univera $20,136 157%
Univera - Wchob $20,136 157%
Blue Cross Blue Shield $20,547 160%
Cigna $20,547 160%
Fallon Health $20,547 160%
Kalos Health $20,547 160%
UnitedHealthcare $20,547 - $20,958 160%
Vns $20,547 160%
Wellcare $20,547 160%
Fidelis $21,575 168%
Aetna $21,780 - $39,064 170%
Centers Plan For Healthy Living $21,780 170%
Upmc $22,191 173%
Magnacare $24,799 194%
Ghi/Emblem Health $26,062 203%
Ghi/Emblem Health - Wchob $26,826 209%
Magnacare - Wchob $32,775 256%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 High Street, Buffalo, NY 14210
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals