CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Good Samaritan Hospital of Suffern

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $25,093
Cash Discount Price: $25,365
vs. Medicare Baseline: 1.96x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Good Samaritan Hospital of Suffern is $25,093. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25,365. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.96x the Medicare baseline. Located in 255 Lafayette Avenue, Suffern, NY.

Cash / Self-Pay

$25,365

Average discount available for prompt cash payment at this facility.

Insurance Median

$25,093

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: $25,365 (198%)

Insurance Median: $25,093 (196%)

Cash: $25,365 (198% of Medicare)

Ins. Median: $25,093 (196% 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
First Health	$1,664	13%
Multiplan	$5,836	46%
Aetna	$16,910 - $52,297	132%
Blue Cross Blue Shield	$16,910	132%
Cdphp	$16,910	132%
Emblem	$16,910 - $73,721	132%
Fidelis	$16,910	132%
Geisinger	$16,910 - $38,386	132%
Hamaspik	$16,910	132%
Magnacare	$16,910 - $68,827	132%
Mvp	$16,910 - $58,796	132%
Non Contracted	$16,910	132%
Oxford	$16,910 - $48,719	132%
Partners Health Plan	$16,910	132%
UnitedHealthcare	$16,910 - $48,719	132%
Wellcare	$16,910	132%
Health First	$18,094	141%
World Trade Center	$25,093	196%
Tricare	$27,045	211%
Cigna	$56,059	438%

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 $25,365.
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 Good Samaritan Hospital of Suffern 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.