CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Saint Thomas Highlands Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $13,248
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Saint Thomas Highlands Hospital is $13,248. 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 1.03x the Medicare baseline. Located in 401 Sewell Dr, Sparta, TN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$13,248

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: $13,248 (103%)
Ins. Median: $13,248 (103% 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.

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
Amerigroup Mcaid Replacement $6,755 - $8,568 53%
Oscar Health $8,394 - $9,510 66%
Cigna $9,564 - $26,246 75%
Smart Health $10,594 - $18,547 83%
UnitedHealthcare $11,485 - $15,974 90%
Point Comfort Underwriters $11,923 93%
Amerigroup Mcr Replacement $13,248 103%
Ascension Complete $13,248 103%
Blue Cross Blue Shield $13,248 - $35,232 103%
Centurion Of Tn $13,248 103%
Covid Uninsured Test Fund $13,248 103%
Healthspring Mcr Replacement $13,248 103%
Humana $13,248 103%
Medicare (plans) $13,248 103%
Nhc Advantage $13,248 103%
Aetna $13,513 - $20,300 106%
Ambetter / Centene $17,223 134%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 401 Sewell Dr, Sparta, TN 38583
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals