CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Good Samaritan Hospital Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $17,071
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.33x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Good Samaritan Hospital Medical Center is $17,071. 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 1.33x the Medicare baseline. Located in 1000 Montauk Highway, West Islip, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$17,071

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: $17,071 (133%)
Ins. Median: $17,071 (133% 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 $7,286 - $10,185 57%
Blue Cross Blue Shield $16,086 - $49,397 126%
Centerlight Healthcare $16,086 126%
Centers Plan For Healthy Living $16,414 128%
Elderplan Inc. $16,414 128%
Emblem Health $16,414 - $42,607 128%
Fidelis Care New York $16,414 128%
Healthspring $16,414 128%
Independent Health $16,414 128%
Liberty Health $16,414 128%
Longevity Health Plan $16,414 128%
Medicare (plans) $16,414 - $17,235 128%
Mvp Health Plans $16,414 - $34,597 128%
Orthonet - Uniformed Services Family Health Plan $16,414 128%
Pmc $16,414 128%
Senior Whole Health $16,414 128%
Tricare $16,414 128%
UnitedHealthcare $16,414 - $49,397 128%
Universal Healthcare $16,414 128%
Veterans Affairs $16,414 128%
Zadroga $16,414 128%
Health First $16,578 - $36,931 129%
Humana $16,742 131%
Agewell New York $16,988 133%
Aetna $17,041 - $40,987 133%
Health Plus $17,041 133%
Wellcare Health Plan Inc $17,071 133%
Partners Health Plan $17,235 135%
Us Family Health Plan $19,905 155%
Centivo $30,006 - $34,597 234%
Local 1199 $33,092 258%
Apwu $34,597 270%
Cigna $34,597 270%
Daniel H Cook $34,597 270%
Nalc $34,597 270%
Samba $34,597 270%
Mail Handlers Benefit Plan $40,987 320%
Meritain Health $40,987 320%
Nippon Life Insurance Company Of America $40,987 320%
Salvation Army $40,987 320%
American Plan Administrators $42,607 333%
Amerihealth Administrators $42,607 333%
Benefit Services $42,607 333%
Ghi Cbp Ny City Employee Alternate $42,607 333%
International Benefit Administrator $42,607 333%
Ultra Benefits Inc. $42,607 333%
Surest $44,268 346%
Self Pay $49,397 386%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Montauk Highway, West Islip, NY 11795
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals