CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: SSM Health St Anthony Hospital - Oklahoma City

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $19,182
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.50x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at SSM Health St Anthony Hospital - Oklahoma City is $19,182. 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 1.50x the Medicare baseline. Located in 1000 North Lee Avenue, Oklahoma City, OK.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$19,182

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: $19,182 (150%)

Ins. Median: $19,182 (150% 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	$15,165 - $35,339	118%
Community Care	$15,165 - $18,198	118%
Generations Healthcare	$15,165	118%
Global Health	$15,165 - $20,419	118%
UnitedHealthcare	$15,165 - $33,385	118%
Phcs	$15,196	119%
Humana	$15,422	120%
Healthcare Highways	$17,729 - $20,472	138%
Oscar	$18,859	147%
Medica	$20,392	159%
Ambetter / Centene	$20,472	160%
Cigna	$22,957	179%
Healthchoice	$23,703	185%
Kempton	$29,571	231%

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 SSM Health St Anthony Hospital - Oklahoma City 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.