CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Mercy Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $17,166
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Mercy Medical Center is $17,166. 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 1000 North Village Avenue, Rockville Centre, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$17,166

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: $17,166 (134%)
Ins. Median: $17,166 (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 $16,385 - $44,012 128%
Emblem Health $16,385 - $41,391 128%
Centerlight Healthcare $16,493 129%
Beacon Health Options $16,829 - $23,561 131%
Beacon Health Strategies $16,829 - $23,561 131%
Centers Plan For Healthy Living $16,829 131%
Elderplan Inc. $16,829 131%
Fidelis Care New York $16,829 131%
Healthspring $16,829 131%
Independent Health $16,829 131%
Liberty Health $16,829 131%
Longevity Health Plan $16,829 131%
Medicare (plans) $16,829 - $17,671 131%
Mvp Health Plans $16,829 - $32,620 131%
Orthonet - Uniformed Services Family Health Plan $16,829 131%
Pmc $16,829 131%
Senior Whole Health $16,829 131%
Tricare $16,829 131%
UnitedHealthcare $16,829 - $44,012 131%
Universal Healthcare $16,829 131%
Veterans Affairs $16,829 131%
Zadroga $16,829 131%
Aetna $16,873 - $37,009 132%
Health Plus $16,873 132%
Health First $16,997 - $37,866 133%
Humana $17,166 134%
Agewell New York $17,418 136%
Wellcare Health Plan Inc $17,502 137%
Partners Health Plan $17,671 138%
Us Family Health Plan $19,961 156%
Centivo $27,098 - $32,620 212%
Apwu $32,620 255%
Cigna $32,620 255%
Daniel H Cook $32,620 255%
Nalc $32,620 255%
Samba $32,620 255%
Local 1199 $33,685 263%
Mail Handlers Benefit Plan $37,009 289%
Meritain Health $37,009 289%
Nippon Life Insurance Company Of America $37,009 289%
Salvation Army $37,009 289%
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 $44,012 344%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 North Village Avenue, Rockville Centre, NY 11571
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals