CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: St Charles Hospital

Billing Code: 322 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$23,134

about 1.8× the $12,807 Medicare rate · typically $16,649–$36,803

modeled estimate · not a bill or quote

What this hospital charges insurers

$21,951

About the fair price

about $1,183 under the fair price · 1.7× Medicare

Medicare pays $12,807 Fair price $23,134 This hospital $21,951

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

Highest price of the 9 NY hospitals we have prices for — worth calling around.

Cheapest $13,595 Priciest $21,951

Black dot = this hospital, among the 9 NY hospitals with a price for this procedure. Full list below.

A fair price for a Heart stent placement (inpatient stay) is about $23,134 (about 1.8× the $12,807 Medicare rate). St Charles Hospital charges insurers about $21,951 — about the fair price. Located in Port Jefferson, NY.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$16,885 - $41,993	132%
Blue Cross Blue Shieldmajor	$16,548 - $41,993	129%
Aetnamajor	$17,027 - $37,678	133%
Cignamajor	$32,620	255%
Humanamajor	$17,223	134%
AmeriHealth	$41,391	323%
Cigna HealthSpring	$16,885	132%
Fidelis Care	$16,885	132%
Independent Health	$16,885	132%
MVP Health Care	$16,885 - $32,620	132%
WellCare	$17,561	137%
+ 32 smaller / regional plans	$6,454 - $41,928

Government programs also on file: Medicare, Military & VA.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 322.

Insurance Before you use insurance

Call your insurance company to confirm St Charles Hospital is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 322.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at St Charles Hospital

Compare: Heart stent placement (inpatient stay) at other NY hospitals

Kenmore Mercy Hospital · Kenmore $13,595
Mercy Hospital of Buffalo · Buffalo $13,595
Montefiore St Luke's Cornwall · Newburgh $15,472
Bertrand Chaffee Hospital · Springville $15,828
Montefiore Mount Vernon Hospital · Mount Vernon $15,834
Montefiore New Rochelle Hospital · New Rochelle $15,906
Glens Falls Hospital · Glens Falls $16,418
Geneva General Hospital · Geneva $16,458

Insurance negotiated median for the same procedure, sorted lowest first.