CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Queens Hospital Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $41,255
Cash Discount Price: Unavailable
vs. Medicare Baseline: 3.22x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Queens Hospital Center is $41,255. 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 3.22x the Medicare baseline. Located in 82-68 164Th Street, Jamaica, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$41,255

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: $41,255 (322%)

Ins. Median: $41,255 (322% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 322% of the Medicare baseline (a markup of 222%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Oscar	$17,861	139%
Local 1199	$22,713	177%
Oxford	$29,479 - $41,255	230%
Cigna	$33,915	265%
Emblem	$34,597 - $41,255	270%
Aetna	$37,266 - $41,255	291%
United	$37,530 - $43,446	293%
Healthfirst	$38,367	300%
Centerlight	$40,430	316%
Blue Cross Blue Shield	$41,255	322%
Elderplan	$41,255	322%
Hamaspik	$41,255	322%
Senior Whole Health	$41,255 - $41,494	322%
Vaccn	$41,255	322%
Vnsny	$41,255	322%
Wellcare	$41,874	327%
Metroplus	$42,492	332%
Centers Plan For Healthy Living	$42,905	335%
Multiplan	$45,317	354%
Villagecare Max	$46,618	364%
Fidelis	$48,681 - $58,582	380%

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 $X.
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 Queens Hospital 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.