CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Montefiore Mount Vernon Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $15,834
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Montefiore Mount Vernon Hospital is $15,834. 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 1.24x the Medicare baseline. Located in 12 North 7Th Avenue, Mount Vernon, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,834

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: $15,834 (124%)
Ins. Median: $15,834 (124% 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
Blue Cross Blue Shield $14,460 113%
Fidelis $14,460 113%
Healthfirst $14,460 113%
Metroplus $14,460 - $18,798 113%
Point Comfort $14,460 113%
UnitedHealthcare $14,460 - $62,003 113%
Villagecaremax $14,460 113%
Wellcare $14,460 113%
Centerlight $14,894 - $15,183 116%
Elderplan $14,894 116%
Emblem $14,894 - $144,728 116%
Humana $14,894 116%
Amidacare $15,183 119%
Vnsny Choice $15,183 119%
Longevity $15,761 123%
Partners Health Plan $15,906 124%
Molina Healthcare Of Ny Affinity $19,955 156%
Oscar $51,364 401%
Aetna $52,133 - $58,316 407%
Cigna $53,875 - $59,861 421%
American Postal Workers $62,003 484%
Centivo $95,694 747%
Northwell $96,845 756%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12 North 7Th Avenue, Mount Vernon, NY 10550
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals