CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Lutheran Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $14,318
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.12x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Lutheran Hospital is $14,318. 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 1.12x the Medicare baseline. Located in 1730 West 25Th Street, Cleveland, OH.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$14,318

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: $14,318 (112%)

Ins. Median: $14,318 (112% 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.

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	$13,964 - $15,516	109%
Aetna	$14,318 - $53,537	112%
Devoted Health	$14,318	112%
Humana	$14,318	112%
Mmo	$14,318 - $17,771	112%
Summacare	$14,318	112%
The Health Plan	$14,318	112%
United	$14,318 - $19,466	112%
United Bh	$14,318	112%
UnitedHealthcare	$14,318	112%
Upmc	$14,318	112%
Valor	$14,318	112%
Cigna	$14,748 - $28,043	115%
Communicare	$15,034	117%
Perennial Health	$15,464	121%
Pphp	$15,750	123%
Zing Health	$15,750	123%

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 Lutheran Hospital 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.