CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Crystal Clinic Orthopaedic Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $27,579
Cash Discount Price: $244,867
vs. Medicare Baseline: 2.15x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Crystal Clinic Orthopaedic Center is $27,579. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $244,867. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 2.15x the Medicare baseline. Located in 444 North Main Street, Akron, OH.

Cash / Self-Pay

$244,867

Average discount available for prompt cash payment at this facility.

Insurance Median

$27,579

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%)

Cash / Self-Pay: $244,867 (1912%)

Insurance Median: $27,579 (215%)

Cash: $244,867 (1912% of Medicare)

Ins. Median: $27,579 (215% 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 215% of the Medicare baseline (a markup of 115%). 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
Bc Mcr Adv	$11,863	93%
Summacare Mcr Adv	$11,863	93%
UnitedHealthcare	$11,863 - $28,855	93%
Bc Pathway	$13,986	109%
Bc Ohi/Ohii	$22,636	177%
The Health Plan - All Plans	$23,725	185%
Summacare Comm - All Other Plans	$25,057	196%
Bc Blue Access	$25,162	196%
Bc Preferred	$25,162	196%
Bc Trad - All Other Plans	$25,162	196%
Med Mutual Aca	$26,302	205%
Med Mutual Medflex	$31,205	244%
Aetna	$32,145	251%
Cigna	$32,285	252%
Aultcare - All Plans	$34,281	268%
Med Mutual Ppo/Pos/Hmo - All Other Plans	$39,166	306%
Health Oh Network - All Plans	$41,977	328%
Ohio Health Choice - All Plans	$41,977	328%
Med Mutual Nas	$43,656	341%
Multiplan - All Plans	$46,175	361%
Healthsmart - All Plans	$59,468	464%

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 $244,867.
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 Crystal Clinic Orthopaedic Center 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.