CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: St Charles Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $17,223
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at St Charles Hospital is $17,223. 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 1.34x the Medicare baseline. Located in 200 Belle Terre Road, Port Jefferson, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$17,223

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: $17,223 (134%)
Ins. Median: $17,223 (134% 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 $6,454 - $9,258 50%
Blue Cross Blue Shield $16,548 - $41,993 129%
Centerlight Healthcare $16,548 129%
Emblem Health $16,742 - $41,391 131%
Beacon Health Options $16,885 - $23,639 132%
Beacon Health Strategies $16,885 - $23,639 132%
Centers Plan For Healthy Living $16,885 132%
Elderplan Inc. $16,885 132%
Fidelis Care New York $16,885 132%
Healthspring $16,885 132%
Independent Health $16,885 132%
Liberty Health $16,885 132%
Longevity Health Plan $16,885 132%
Medicare (plans) $16,885 - $17,730 132%
Mvp Health Plans $16,885 - $32,620 132%
Orthonet - Uniformed Services Family Health Plan $16,885 132%
Pmc $16,885 132%
Senior Whole Health $16,885 132%
Tricare $16,885 132%
UnitedHealthcare $16,885 - $41,993 132%
Universal Healthcare $16,885 132%
Veterans Affairs $16,885 132%
Zadroga $16,885 132%
Aetna $17,027 - $37,678 133%
Health Plus $17,027 133%
Health First $17,054 - $37,992 133%
Humana $17,223 134%
Agewell New York $17,476 136%
Wellcare Health Plan Inc $17,561 137%
Partners Health Plan $17,730 138%
Us Family Health Plan $19,905 155%
Centivo $27,581 - $32,620 215%
Local 1199 $28,960 226%
Apwu $32,620 255%
Cigna $32,620 255%
Daniel H Cook $32,620 255%
Nalc $32,620 255%
Samba $32,620 255%
Mail Handlers Benefit Plan $37,678 294%
Meritain Health $37,678 294%
Nippon Life Insurance Company Of America $37,678 294%
Salvation Army $37,678 294%
American Plan Administrators $41,391 323%
Amerihealth Administrators $41,391 323%
Benefit Services $41,391 323%
Ghi Cbp Ny City Employee Alternate $41,391 323%
International Benefit Administrator $41,391 323%
Ultra Benefits Inc. $41,391 323%
Surest $41,928 327%
Self Pay $41,993 328%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Belle Terre Road, Port Jefferson, NY 11777
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals