CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Westchester Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $35,162
Cash Discount Price: $96,915
vs. Medicare Baseline: 2.75x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Westchester Medical Center is $35,162. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $96,915. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 2.75x the Medicare baseline. Located in 100 Woods Rd, Valhalla, NY.

Cash / Self-Pay

$96,915

Average discount available for prompt cash payment at this facility.

Insurance Median

$35,162

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: $96,915 (757%)

Insurance Median: $35,162 (275%)

Cash: $96,915 (757% of Medicare)

Ins. Median: $35,162 (275% 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 275% of the Medicare baseline (a markup of 175%). 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
Value Options	$1,523 - $1,539	12%
Emblem	$12,065 - $90,218	94%
Va	$13,840	108%
Cdphp	$19,467 - $90,849	152%
Aetna	$19,772 - $81,304	154%
Blue Cross Blue Shield	$19,772 - $93,185	154%
Cigna	$19,772 - $88,825	154%
Health First	$19,772	154%
Magnacare	$19,772 - $112,747	154%
Mvp	$19,772 - $76,514	154%
Non Contracted	$19,772	154%
Oxford	$19,772 - $75,576	154%
Partners Health Plan	$19,772	154%
Todays Options	$19,772	154%
UnitedHealthcare	$19,772 - $75,576	154%
Wellcare	$19,772 - $36,578	154%
Oscar	$20,365	159%
Vns Choice	$20,365	159%
Molina	$20,760	162%
Tricare	$35,162	275%

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 $96,915.
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 Westchester Medical 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.