CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: St Catherine of Siena Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $15,969
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at St Catherine of Siena Hospital is $15,969. 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 1.25x the Medicare baseline. Located in 50 Route 25A, Smithtown, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,969

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: $15,969 (125%)
Ins. Median: $15,969 (125% 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 $15,343 - $42,802 120%
Centerlight Healthcare $15,343 120%
Aetna $15,656 - $37,154 122%
Beacon Health Options $15,656 - $21,918 122%
Beacon Health Strategies $15,656 - $21,918 122%
Centers Plan For Healthy Living $15,656 122%
Elderplan Inc. $15,656 122%
Emblem Health $15,656 - $41,391 122%
Fidelis Care New York $15,656 122%
Health Plus $15,656 122%
Healthspring $15,656 122%
Independent Health $15,656 122%
Liberty Health $15,656 122%
Longevity Health Plan $15,656 122%
Medicare (plans) $15,656 - $16,439 122%
Mvp Health Plans $15,656 - $32,620 122%
Orthonet - Uniformed Services Family Health Plan $15,656 122%
Pmc $15,656 122%
Senior Whole Health $15,656 122%
Tricare $15,656 122%
UnitedHealthcare $15,656 - $42,802 122%
Universal Healthcare $15,656 122%
Veterans Affairs $15,656 122%
Zadroga $15,656 122%
Health First $15,813 - $35,226 123%
Humana $15,969 125%
Agewell New York $16,204 127%
Wellcare Health Plan Inc $16,282 127%
Partners Health Plan $16,439 128%
Us Family Health Plan $19,905 155%
Centivo $27,205 - $32,620 212%
Local 1199 $28,960 226%
Apwu $32,620 255%
Cigna $32,620 255%
Daniel H Cook $32,620 255%
Nalc $32,620 255%
Samba $32,620 255%
Mail Handlers Benefit Plan $37,154 290%
Meritain Health $37,154 290%
Nippon Life Insurance Company Of America $37,154 290%
Salvation Army $37,154 290%
Surest $40,314 315%
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%
Self Pay $42,802 334%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 50 Route 25A, Smithtown, NY 11787
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals