CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Texas Orthopedic Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $12,857
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Texas Orthopedic Hospital is $12,857. 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 1.00x the Medicare baseline. Located in 7401 South Main Street, Houston, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$12,857

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: $12,857 (100%)
Ins. Median: $12,857 (100% 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
Aetna $1,779 - $4,272 14%
Coventry National First Health $1,941 - $2,855 15%
United $3,368 - $40,000 26%
Humana $12,214 - $25,863 95%
Oscar $12,353 - $20,609 96%
Cigna $12,479 - $35,854 97%
Wellmed $12,479 97%
Amerigroup $12,605 98%
Blue Cross Blue Shield $12,605 98%
Kelsey Seybold $12,605 98%
Texas Healthcare Foundation $12,605 98%
Triwest Healthcare Alliance $12,605 98%
Van Lang Ipa $12,731 99%
Devoted Health $12,857 100%
Integranet Amerigroup Ipa $12,857 100%
Provider Partners Health Plan Of Texas $12,857 100%
American Health Plan $13,236 103%
Procare Advantage $13,236 103%
Superior Health Plan $13,236 103%
Texas Independent Health Plan $13,362 104%
Wellcare $13,362 104%
Shared Health $13,488 105%
Universal Healthcare Group $13,614 106%
Molina $13,740 107%
Verda Health Plan $13,866 108%
Fidelis Securecare Of Tx $14,118 110%
Averde Health $15,867 124%
Imagine Health $17,491 137%
Corvel Corporation $17,845 139%
Community Health Choice $18,278 143%
Omni Healthcare $18,927 148%
Superior $19,538 153%
Healthcare Highways $21,450 167%
Curative Administrators $24,061 188%
Evry Health $24,645 192%
Molina Healthcare $26,240 205%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7401 South Main Street, Houston, TX 77030
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals