CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: St John's Episcopal Hospital at South Shore

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $24,084
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.88x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at St John's Episcopal Hospital at South Shore is $24,084. 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 1.88x the Medicare baseline. Located in 327 Beach 19Th Street, Far Rockaway, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$24,084

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: $24,084 (188%)
Ins. Median: $24,084 (188% 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
UnitedHealthcare $19,494 - $24,084 152%
Aetna $22,792 - $24,084 178%
Vns $22,880 - $24,084 179%
Blue Cross Blue Shield $24,084 - $32,241 188%
Centerlight $24,084 188%
Centers Plan For Healthy Living $24,084 188%
Elderplan $24,084 188%
Emblem Health $24,084 - $43,157 188%
Fidelis $24,084 188%
Hamaspik $24,084 188%
Humana $24,084 188%
Longevity $24,084 188%
Lucida $24,084 188%
Metroplus $24,084 188%
Village Care Max $24,084 188%
Wellcare $24,084 188%
1199 National Benefit Fund $24,484 191%
Cigna $24,674 193%
Molina $26,493 207%
Magnacare $32,506 254%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 327 Beach 19Th Street, Far Rockaway, NY 11691
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals