CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Jefferson Lansdale Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $13,846
Cash Discount Price: $14,111
vs. Medicare Baseline: 1.08x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Jefferson Lansdale Hospital is $13,846. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14,111. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.08x the Medicare baseline. Located in 100 Medical Campus Drive, Lansdale, PA.

Cash / Self-Pay

$14,111

Average discount available for prompt cash payment at this facility.

Insurance Median

$13,846

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: $14,111 (110%)

Insurance Median: $13,846 (108%)

Cash: $14,111 (110% of Medicare)

Ins. Median: $13,846 (108% 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
Jefferson Health Plan Aca Qhp Exchange	$12,108	95%
Inspira Life	$12,587	98%
Medicare (plans)	$12,587 - $14,475	98%
Point Of Comfort Refugee Resettlement	$12,587	98%
Provider Partners Health Plan	$12,587	98%
Tricare	$12,587	98%
UnitedHealthcare	$12,587 - $25,380	98%
Humana	$12,839	100%
Innovage	$12,839	100%
Cigna	$13,091 - $33,014	102%
Devoted Health Participation	$13,217	103%
Aetna	$13,343 - $30,020	104%
Keystone First Vip Choice	$13,343	104%
Allwell Pa Health_Wellness Ma	$13,846	108%
Highmark Wholecare Gateway	$13,846	108%
St Agnes	$14,080	110%
Perennial	$14,601	114%
Ibc Employee Benefit	$15,734	123%
Ibc Main Line Health	$15,734	123%
Ambetter / Centene	$18,871	147%
Naphcare	$20,140	157%
Highmark	$21,342 - $26,444	167%
Blue Cross Blue Shield	$23,899 - $25,738	187%
Upmc Commercial	$33,014	258%
Geisinger Health Plan	$56,711	443%

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 $14,111.
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 Jefferson Lansdale 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.