CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Penn State Health St. Joseph

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $14,624
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Penn State Health St. Joseph is $14,624. 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 1.14x the Medicare baseline. Located in 2500 Bernville Road, Reading, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$14,624

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: $14,624 (114%)

Ins. Median: $14,624 (114% 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
[Ibc]	$6,099 - $14,551	48%
[Highmark]	$14,406 - $59,399	112%
Aetna	$14,551 - $32,268	114%
UnitedHealthcare	$14,551 - $36,924	114%
[Amerihealth Caritas]	$14,551	114%
[Cbc]	$14,551 - $35,305	114%
[Geisinger]	$14,551	114%
[Highmark Wholecare]	$14,551	114%
Humana	$14,697	115%
[Healthspring]	$14,697	115%
[Health Partners Plans]	$14,842	116%
[Pa Health & Wellness]	$14,988	117%
[Upmc]	$15,280	119%
[Point Comfort Underwriters]	$18,189	142%
Cigna	$34,431	269%
[Highmark Choice Blue]	$47,519	371%
[Highmark Aca]	$49,895	390%

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 Penn State Health St. Joseph 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.