CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: UT of Texas Southwestern University Hospital - William P. Clements Jr.

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $31,701
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.48x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at UT of Texas Southwestern University Hospital - William P. Clements Jr. is $31,701. 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 2.48x the Medicare baseline. Located in 6201 Harry Hines Blvd, Dallas, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$31,701

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: $31,701 (248%)

Ins. Median: $31,701 (248% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 248% of the Medicare baseline (a markup of 148%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Procare	$15,850	124%
Humana	$16,484	129%
Blue Cross Blue Shield	$16,643 - $61,661	130%
Molina	$16,643	130%
Superior	$16,643	130%
Wellpoint	$16,643	130%
UnitedHealthcare	$17,594 - $56,578	137%
Aetna	$23,784 - $53,785	186%
Ambetter / Centene	$31,701	248%
Coventry	$33,146	259%
Cigna	$42,697	333%
United Options Nexus	$60,623	473%

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 UT of Texas Southwestern University Hospital - William P. Clements Jr. 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.