CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Montefiore St Luke's Cornwall

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $15,472
Cash Discount Price: $18,522
vs. Medicare Baseline: 1.21x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Montefiore St Luke's Cornwall is $15,472. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18,522. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.21x the Medicare baseline. Located in 70 Dubois Street, Newburgh, NY.

Cash / Self-Pay

$18,522

Average discount available for prompt cash payment at this facility.

Insurance Median

$15,472

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: $18,522 (145%)

Insurance Median: $15,472 (121%)

Cash: $18,522 (145% of Medicare)

Ins. Median: $15,472 (121% 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.

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
UnitedHealthcare	$14,171 - $53,222	111%
Aetna	$14,315	112%
Affinity	$14,460 - $15,472	113%
Blue Cross Blue Shield	$14,460	113%
Cdphp	$14,460	113%
Fidelis	$14,460	113%
Healthfirst	$14,460	113%
Hudson Valley	$14,460	113%
Mediblue	$14,460	113%
Oscar	$14,460 - $51,364	113%
Point Comfort	$14,460	113%
Centerlight	$14,894	116%
Emblem	$14,894 - $144,726	116%
Humana	$14,894	116%
Wellcare	$14,894	116%
Vnsny Choice	$15,183	119%
Hamaspik	$15,906	124%
Magnacare	$17,006	133%
Cigna	$53,875 - $59,861	421%
Centivo	$85,061	664%
Northwell	$86,082	672%

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 $18,522.
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 Montefiore St Luke's Cornwall 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.