CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Arthur G James Cancer Hospital and Research Institute

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $40,404
Cash Discount Price: Unavailable
vs. Medicare Baseline: 3.15x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Arthur G James Cancer Hospital and Research Institute is $40,404. 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 3.15x the Medicare baseline. Located in 460 W 10Th Ave, Columbus, OH.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$40,404

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: $40,404 (315%)

Ins. Median: $40,404 (315% 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 315% of the Medicare baseline (a markup of 215%). 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
Ohio Dept Of Health	$4,289	33%
Aetna	$5,388 - $66,513	42%
Molina	$5,388 - $38,534	42%
Healthspan	$5,413 - $46,840	42%
Upper Ohio Valley	$5,413 - $64,015	42%
Medicare (plans)	$5,467	43%
Humana	$5,521 - $50,041	43%
Medicaid / KanCare	$27,136	212%
Odrc	$27,136	212%
Buckeye Community	$28,807 - $38,261	225%
United	$29,853 - $55,061	233%
Osu Health Plan	$35,653 - $51,672	278%
Caresource	$35,911 - $38,534	280%
Amerihealth	$42,062	328%
Lifetrac	$50,743	396%
Ohio Ppo	$51,227	400%
Blue Cross Blue Shield	$52,391 - $72,868	409%
Ohiohealth	$56,208 - $56,989	439%
Cigna	$56,575	442%
Mmo	$58,933 - $62,087	460%
Frontpath	$62,454	488%
Healthsmart	$70,260	549%
Multiplan	$72,602	567%

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 Arthur G James Cancer Hospital and Research Institute 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.