CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Lafollette Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $13,624
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Lafollette Medical Center is $13,624. 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 1.06x the Medicare baseline. Located in 923 East Central Avenue, La Follette, TN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$13,624

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: $13,624 (106%)
Ins. Median: $13,624 (106% 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
Medicaid / KanCare $1,306 - $7,162 10%
UnitedHealthcare $1,306 - $15,049 10%
Beech Street Work Comp Tn $2,225 17%
Novanet Work Comp Tn $2,324 18%
Tn Work Comp $2,347 18%
Self Pay $5,048 39%
Blue Cross Blue Shield $5,268 - $26,270 41%
Aetna $7,162 - $14,032 56%
Wellcare $7,162 56%
Bluecare $7,383 - $9,219 58%
Node Bluecare Plus Tn Mcr Adv $11,462 89%
Multiplan Complementary $13,364 104%
Triwest $13,590 106%
Humana $13,624 106%
Medicare (plans) $13,624 106%
Node Wellcare Mcr Adv $13,867 108%
Node Devoted Health Mcr Adv $13,896 109%
Node Farm Bureau Mcr Adv $13,896 109%
Node Blueadvantage Mcr Adv $14,032 110%
Node Healthspring Mcr Adv $14,032 110%
Node Va $14,144 110%
Node Amerigroup Mcr Adv $14,304 112%
Windsor Health Plan $14,304 112%
Node Nhc Mcr Adv $14,983 117%
Cigna $19,023 149%
Node Us Dept Of Labor $20,165 157%
Ambetter / Centene $25,654 200%
Node Point Comfort Underwriters $30,507 238%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 923 East Central Avenue, La Follette, TN 37766
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals