CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: St Francis Hospital - the Heart Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $16,333
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.28x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at St Francis Hospital - the Heart Center is $16,333. 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 1.28x the Medicare baseline. Located in 100 Port Washington Boulevard, Roslyn, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$16,333

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: $16,333 (128%)
Ins. Median: $16,333 (128% 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
Brighton $9,878 - $12,625 77%
Blue Cross Blue Shield $15,390 - $56,326 120%
Centerlight Healthcare $15,390 120%
Centers Plan For Healthy Living $15,705 123%
Elderplan Inc. $15,705 123%
Emblem Health $15,705 - $67,442 123%
Fidelis Care New York $15,705 123%
Healthspring $15,705 123%
Independent Health $15,705 123%
Liberty Health $15,705 123%
Longevity Health Plan $15,705 123%
Medicare (plans) $15,705 - $16,490 123%
Mvp Health Plans $15,705 - $46,952 123%
Orthonet - Uniformed Services Family Health Plan $15,705 123%
Pmc $15,705 123%
Senior Whole Health $15,705 123%
Tricare $15,705 123%
UnitedHealthcare $15,705 - $56,326 123%
Universal Healthcare $15,705 123%
Veterans Affairs $15,705 123%
Zadroga $15,705 123%
Health First $15,862 - $35,335 124%
Aetna $15,951 - $56,644 125%
Health Plus $15,951 125%
Humana $16,019 125%
Agewell New York $16,254 127%
Wellcare Health Plan Inc $16,333 128%
Partners Health Plan $16,490 129%
Us Family Health Plan $19,905 155%
Local 1199 $31,958 250%
Centivo $39,670 - $46,952 310%
Apwu $46,952 367%
Cigna $46,952 367%
Daniel H Cook $46,952 367%
Nalc $46,952 367%
Samba $46,952 367%
Surest $55,937 437%
Self Pay $56,326 440%
Mail Handlers Benefit Plan $56,644 442%
Meritain Health $56,644 442%
Nippon Life Insurance Company Of America $56,644 442%
Salvation Army $56,644 442%
American Plan Administrators $67,442 527%
Amerihealth Administrators $67,442 527%
Benefit Services $67,442 527%
Ghi Cbp Ny City Employee Alternate $67,442 527%
International Benefit Administrator $67,442 527%
Ultra Benefits Inc. $67,442 527%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Port Washington Boulevard, Roslyn, NY 11576
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals