CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Hospital of Univ of Pennsylvania

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $15,909
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Hospital of Univ of Pennsylvania is $15,909. 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 1.24x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,909

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: $15,909 (124%)
Ins. Median: $15,909 (124% 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Paired Kidney Exchange $1,683 13%
UnitedHealthcare $3,308 - $41,842 26%
Kaiser Permanente $4,084 - $15,009 32%
Interlink $4,368 34%
Blue Quality Centers For Transplant (Bqct) $4,387 34%
Penn Life (Living Independently For Elders) $4,748 37%
Cigna $4,910 - $37,164 38%
Us Family Health Plan $6,155 48%
Pgm - Embassy Of Qatar $11,430 89%
Pgm - Embassy Of The United Emirates/Ipc $12,309 96%
Blue Cross Blue Shield $15,009 - $77,963 117%
Medicare (plans) $15,009 - $19,587 117%
Upmc $15,009 117%
Geisinger Health Plan $15,459 - $53,145 121%
Health Partners $15,459 121%
Humana $15,459 121%
Ibc $15,620 122%
Devoted Health $15,759 123%
Keystone First $15,759 123%
Pa Health And Wellness $15,759 - $32,319 123%
Aetna $15,909 - $36,963 124%
Clover Health Plan $15,909 124%
Gateway Health Plan $16,365 128%
Workers Compensation $17,408 136%
Ibc Commercial Hpn $17,584 137%
Keystone Hmo Proactive $17,584 137%
Philadelphia Va Medical Center $19,587 153%
Elap $27,814 217%
Claims Watcher $31,340 - $35,257 245%
Oscar Health Plan $33,299 260%
Centivo $35,257 275%
Elap Services $36,433 284%
Olympus $37,522 293%
Highmark $44,403 347%
Penn Global Medicine $51,907 405%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals