CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: SSM Health St Agnes Hospital-Fond Du Lac

Billing Code: 322 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$23,347

about 1.8× the $12,807 Medicare rate · typically $13,584–$27,964

modeled estimate · not a bill or quote

What this hospital charges insurers

$23,589

About the fair price

about $242 over the fair price · 1.8× Medicare

Medicare pays $12,807 Fair price $23,347 This hospital $23,589

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

Highest price of the 9 WI hospitals we have prices for — worth calling around.

Cheapest $10,940 Priciest $23,589

Black dot = this hospital, among the 9 WI hospitals with a price for this procedure. Full list below.

A fair price for a Heart stent placement (inpatient stay) is about $23,347 (about 1.8× the $12,807 Medicare rate). SSM Health St Agnes Hospital-Fond Du Lac charges insurers about $23,589 — about the fair price. Located in Fond Du Lac, WI.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Humana AetnaCignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$12,909 - $26,556	101%
Blue Cross Blue Shieldmajor	$12,909 - $27,498	101%
Humanamajor	$12,909	101%
Dean Health Plan	$12,909	101%
Molina	$9,682	76%
Quartz	$24,105	188%
WellCare	$13,167	103%
+ 9 smaller / regional plans	$12,909 - $36,268

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 322.

Insurance Before you use insurance

Call your insurance company to confirm SSM Health St Agnes Hospital-Fond Du Lac is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 322.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at SSM Health St Agnes Hospital-Fond Du Lac

Compare: Heart stent placement (inpatient stay) at other WI hospitals

Memorial Hospital of Lafayette County · Darlington $10,940
Orthopaedic Hospital of Wisconsin · Glendale $12,084
Sauk Prairie Hospital · Prairie Du Sac $12,461
Oakleaf Surgical Hospital · Altoona $12,485
The Monroe Clinic · Monroe $12,539
Mile Bluff Medical Center · Mauston $12,679
Beloit Health System · Beloit $14,422
Ascension Sacred Heart Rehabilitation Hospital · Mequon $15,202

Insurance negotiated median for the same procedure, sorted lowest first.