CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Metrohealth System

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $22,252
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.74x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Metrohealth System is $22,252. 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 1.74x the Medicare baseline. Located in 2500 Metrohealth Drive, Cleveland, OH.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$22,252

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: $22,252 (174%)
Ins. Median: $22,252 (174% 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
Ohio Health Choice $10,578 83%
Aetna $16,886 - $33,378 132%
Summacare $18,247 142%
Blue Cross Blue Shield $18,781 - $24,393 147%
Medical Mutual $19,980 - $26,639 156%
Cigna $20,624 - $22,252 161%
Aarp $22,252 174%
Buckeye Health Plan $22,252 - $29,150 174%
Caresource $22,252 - $31,153 174%
Clover $22,252 174%
Communicare $22,252 174%
Devoted Health $22,252 174%
Humana $22,252 174%
Molina Healthcare $22,252 - $31,153 174%
Paramount $22,252 174%
UnitedHealthcare $22,252 - $28,927 174%
Valor Health $22,474 175%
Perennial Advantage $22,697 177%
Mcgregor Pace $24,477 191%
Metrohealth $27,815 217%
Clarity Health $28,927 226%
Health E Ohio $33,378 261%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2500 Metrohealth Drive, Cleveland, OH 44109
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals