CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Ohio State University State Health System

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $31,034
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.42x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Ohio State University State Health System is $31,034. 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 2.42x the Medicare baseline. Located in 410 West 10Th Avenue, Columbus, OH.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$31,034

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: $31,034 (242%)

Ins. Median: $31,034 (242% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 242% of the Medicare baseline (a markup of 142%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$11,237 - $73,078	88%
Healthspan	$11,237 - $37,472	88%
Medigold	$11,237	88%
Ohio Dept Of Health	$11,237	88%
Upper Ohio Valley	$11,237 - $51,524	88%
Aetna	$11,402 - $62,766	89%
Medicare (plans)	$11,402 - $12,136	89%
Mmo	$11,402 - $33,621	89%
Humana	$11,462 - $29,463	89%
Caresource	$11,972 - $17,672	93%
Molina	$11,972 - $19,041	93%
Buckeye Community	$17,079 - $25,701	133%
Cigna	$27,024	211%
Osu Health Plan	$29,946 - $39,033	234%
Ohio Ppo	$34,982	273%
United	$35,986	281%
Ohiohealth	$50,743 - $56,989	396%
Lifetrac	$53,085	414%
Frontpath	$62,454	488%
Multiplan	$62,454	488%
Healthsmart	$70,260	549%

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 $X.
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 Ohio State University State Health System 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.