CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Mercy Health - West Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $16,900
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.32x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Mercy Health - West Hospital is $16,900. 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 1.32x the Medicare baseline. Located in 3300 Mercy Health Blvd, Cincinnati, OH.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$16,900

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: $16,900 (132%)
Ins. Median: $16,900 (132% 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
Aetna $13,520 - $34,539 106%
Blue Cross Blue Shield $13,520 - $33,000 106%
Humana $13,520 106%
Medigold [4435] $13,520 106%
Paramount Elite [3723] $13,520 106%
UnitedHealthcare $13,520 - $33,432 106%
Devoted Health Plan [4501] $13,655 107%
Caresource Mycare Ohio [4236] $13,790 108%
Medicare (plans) $13,790 108%
Buckeye Mycare Benefits [4237] $14,196 111%
Molina Mycare Ohio [4235] $14,196 111%
Caresource [4179] $19,604 153%
Buckeye [4178] $20,956 164%
Molina Marketplace Aca [4181] $23,119 181%
Cigna $26,085 204%
Medical Mutual [3067] $32,362 253%
Meritain Health [3068] $34,539 270%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3300 Mercy Health Blvd, Cincinnati, OH 45211
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals