CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Unitypoint Health - Meriter

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $19,522
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.52x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Unitypoint Health - Meriter is $19,522. 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 1.52x the Medicare baseline. Located in 202 S Park St, Madison, WI.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$19,522

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: $19,522 (152%)

Ins. Median: $19,522 (152% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aspirus	$14,247	111%
Blue Cross Blue Shield	$14,247 - $44,939	111%
Humana	$14,247	111%
Illinicare	$14,247	111%
Meridiancare	$14,247	111%
Prevea 360	$14,247	111%
UnitedHealthcare	$14,247 - $28,739	111%
Medical Associates Health Plan	$18,544	145%
Quartz	$20,500	160%
Cigna	$36,365	284%
Health Partners Open Network	$40,450	316%
Wellmark Uph Self-Funded	$44,939	351%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 322.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Unitypoint Health - Meriter is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 322.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.