CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Saint Vincent Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $15,756
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Saint Vincent Hospital is $15,756. 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 1.23x the Medicare baseline. Located in 232 West 25Th Street, Erie, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$15,756

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: $15,756 (123%)

Ins. Median: $15,756 (123% 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
Highmark	$13,510 - $44,338	105%
Independent Health	$14,299 - $18,356	112%
Fidelis	$14,685 - $15,311	115%
Life Pittsburgh	$14,685	115%
The Health Plan Of The Upper Ohio Valley	$14,685 - $16,153	115%
UnitedHealthcare	$14,685 - $15,859	115%
Univera	$14,685 - $27,167	115%
University Of Pittsburgh Medical Center	$14,896 - $15,799	116%
Blue Cross Blue Shield	$15,125	118%
Aetna	$15,272 - $26,751	119%
Amerihealth	$15,419	120%
Highmark Wholecare	$15,566	122%
Humana	$15,566	122%
Medicare (plans)	$15,566 - $17,034	122%
Cigna	$15,713 - $24,218	123%
Jefferson Health Plans	$15,859	124%
Molina	$16,006	125%
American Health Plans	$16,153	126%
Martin'S Point	$22,414	175%
Medical Mutual	$24,218	189%

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 Saint Vincent 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.