CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Baylor Scott and White Medical Center Lake Pointe

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $16,959
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.32x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Baylor Scott and White Medical Center Lake Pointe is $16,959. 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 1.32x the Medicare baseline. Located in 6800 Scenic Dr, Rowlett, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$16,959

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: $16,959 (132%)
Ins. Median: $16,959 (132% 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
Baylor Scott & White Health Plan $13,426 - $25,439 105%
Humana $14,133 110%
Triwest $14,133 110%
Wellpoint (Fka Amerigroup) $14,557 114%
Corvel $14,806 116%
Prime Health Services $14,806 116%
American Health Plan $14,839 116%
Blue Cross Blue Shield $14,839 - $26,434 116%
Healthspring $14,839 116%
Molina $14,839 116%
Procare Advantage $14,839 116%
Superior Health Plan $14,839 116%
University Of Mary Hardin-Baylor $15,568 122%
UnitedHealthcare $16,253 - $41,250 127%
Cigna $22,411 - $26,365 175%
Healthsmart $24,262 - $32,902 189%
Employers Health Network $24,951 195%
Private Health Care System $26,466 207%
Ambetter / Centene $31,940 249%
Aetna $33,685 263%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6800 Scenic Dr, Rowlett, TX 75088
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals