CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Methodist Midlothian Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $15,114
  • Cash Discount Price: $90,019
  • vs. Medicare Baseline: 1.18x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Methodist Midlothian Medical Center is $15,114. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90,019. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.18x the Medicare baseline. Located in 1201 E Highway 287, Midlothian, TX.
Cash / Self-Pay
$90,019

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,114

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: $90,019 (703%)
Insurance Median: $15,114 (118%)
Cash: $90,019 (703% of Medicare)
Ins. Median: $15,114 (118% 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
UnitedHealthcare $11,061 - $13,463 86%
Ust Health Proof [1005] $11,061 86%
Aetna $12,701 - $20,576 99%
Blue Cross Blue Shield $12,701 - $13,463 99%
Covid19 Hrsa Uninsured Testing And Treatment Fund [6005] $12,701 99%
Medicare (plans) $12,701 - $13,590 99%
Wellcare [7016] $12,701 99%
American Health Advantage Of Texas [7099] $13,336 104%
Cigna $13,336 - $20,806 104%
Globalhealth [1003] $13,336 104%
Procare Advantage [7018] $13,336 104%
Humana $13,463 105%
Southwestern Health Resources Swhr [7015] $13,463 105%
Provider Partners Health Plan [7025] $13,971 109%
Mcs Advantage, Inc Classicare [7021] $14,352 112%
Medical Card System [2063] $14,352 112%
Alternative Service Concepts [8005] $15,876 124%
Oscar Insurance Company [2057] $17,782 139%
Department Of Labor [8004] $18,163 142%
Generic Workers Comp Tx Non Par [9010] $18,163 142%
Generic Workers Comp Tx Par [8002] $18,163 142%
Generic Workers Comp Tx Par [9011] $18,163 142%
Tristar Risk Management [8006] $18,163 142%
Molina [3017] $18,417 144%
Bright Healthcare [2222] $18,713 146%
Sana Benefits [3069] $19,052 149%
Wellpoint Marketplace Exchange [3071] $19,687 154%
Web Tpa [3049] $20,806 162%
90 Degree Benefit [3057] $20,957 164%
Allied National [2031] $20,957 164%
Entrust/90 Degree [2058] $20,957 164%
Kempton Group Administrators, Tower Extrusions [3061] $21,156 165%
Friday Health Plan [2061] $21,592 169%
Ambetter / Centene $21,719 170%
Imperial Insurance Companies [3073] $22,862 179%
Evry Health [1013] $31,753 248%
Medical Cost Containment Professionals [3059] $31,753 248%
Velocity [3070] $31,753 248%
Dart Member Care [3039] $34,293 268%
Healthscope Benefits [2052] $34,293 268%
Healthscope Benefits [3063] $34,293 268%
Medicaid / KanCare $56,541 441%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1201 E Highway 287, Midlothian, TX 76065
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals