CMS Price Transparency Data
Heart stent placement (inpatient stay)
Facility: Methodist Southlake Medical Center
Billing Code: 322 (MS-DRG)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 322
- Insurance Median: $20,456
- Cash Discount Price: $43,300
- vs. Medicare Baseline: 1.60x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Methodist Southlake Medical Center is $20,456. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43,300. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.60x the Medicare baseline. Located in 421 E State Highway 114, Southlake, TX.
Cash / Self-Pay
$43,300
Average discount available for prompt cash payment at this facility.
Insurance Median
$20,456
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%)
Cash / Self-Pay: $43,300 (338%)
Insurance Median: $20,456 (160%)
Cash: $43,300 (338% of Medicare)
Ins. Median: $20,456 (160% 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
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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 |
|---|---|---|
| UnitedHealthcare | $11,572 - $33,494 | 90% |
| Aetna | $12,627 - $29,967 | 99% |
| Blue Cross Blue Shield | $12,627 - $33,607 | 99% |
| Medicare (plans) | $12,627 - $13,511 | 99% |
| Ust Health Proof [1005] | $12,627 | 99% |
| Wellcare [7016] | $12,627 | 99% |
| American Health Advantage Of Texas [7099] | $13,258 | 104% |
| Cigna | $13,258 - $20,806 | 104% |
| Globalhealth [1003] | $13,258 | 104% |
| Procare Advantage [7018] | $13,258 | 104% |
| Humana | $13,385 | 105% |
| Southwestern Health Resources Swhr [7015] | $13,385 | 105% |
| Provider Partners Health Plan [7025] | $13,890 | 108% |
| Mcs Advantage, Inc Classicare [7021] | $14,268 | 111% |
| Medical Card System [2063] | $14,268 | 111% |
| Alternative Service Concepts [8005] | $15,784 | 123% |
| Oscar Insurance Company [2057] | $17,678 | 138% |
| Department Of Labor [8004] | $18,056 | 141% |
| Generic Workers Comp Tx Non Par [9010] | $18,056 | 141% |
| Generic Workers Comp Tx Par [8002] | $18,056 | 141% |
| Generic Workers Comp Tx Par [9011] | $18,056 | 141% |
| Tristar Risk Management [8006] | $18,056 | 141% |
| Molina [3017] | $18,309 | 143% |
| Bright Healthcare [2222] | $18,713 | 146% |
| Sana Benefits [3069] | $18,940 | 148% |
| Wellpoint Marketplace Exchange [3071] | $19,572 | 153% |
| Web Tpa [3049] | $20,806 - $29,967 | 162% |
| 90 Degree Benefit [3057] | $20,834 | 163% |
| Allied National [2031] | $20,834 | 163% |
| Entrust/90 Degree [2058] | $20,834 | 163% |
| Kempton Group Administrators, Tower Extrusions [3061] | $21,156 | 165% |
| Friday Health Plan [2061] | $21,466 | 168% |
| Ambetter / Centene | $21,592 | 169% |
| Champva [1000] | $22,414 | 175% |
| Tricare | $22,414 | 175% |
| Triwest Wps [8010] | $22,414 | 175% |
| Veterans Administration [9001] | $22,414 | 175% |
| Imperial Insurance Companies [3073] | $22,728 | 177% |
| Scott & White Health Plan Trs [3062] | $25,694 | 201% |
| Evry Health [1013] | $31,567 | 246% |
| Medical Cost Containment Professionals [3059] | $31,567 | 246% |
| Velocity [3070] | $31,567 | 246% |
| Bind Benefits Inc [1004] | $33,494 | 262% |
| Definity Health [3006] | $33,494 | 262% |
| Freedom Life Insurance Company [2029] | $33,494 | 262% |
| Geha Federal [3066] | $33,494 | 262% |
| Tml Intergovernmental Employee Benefits [3050] | $33,494 | 262% |
| Dart Member Care [3039] | $34,093 | 266% |
| Healthscope Benefits [2052] | $34,093 | 266% |
| Healthscope Benefits [3063] | $34,093 | 266% |
| Medicaid / KanCare | $35,684 - $60,028 | 279% |