CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Froedtert Memorial Lutheran Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $34,560
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.70x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Froedtert Memorial Lutheran Hospital is $34,560. 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 2.70x the Medicare baseline. Located in 9200 W Wisconsin Ave, Milwaukee, WI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$34,560

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: $34,560 (270%)
Ins. Median: $34,560 (270% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 270% of the Medicare baseline (a markup of 170%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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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
Blue Cross Blue Shield $18,122 - $65,592 141%
Community Care $18,122 141%
Health Partners $18,122 - $36,025 141%
Humana $18,122 141%
Icare $18,122 141%
Molina $18,122 141%
Network Health Plan $18,122 - $38,400 141%
Priority Health $18,122 141%
Quartz $18,122 141%
Security Health Plan $18,122 141%
UnitedHealthcare $18,122 - $58,479 141%
Upper Peninsula Health Plan $18,122 141%
Aetna $18,484 144%
Wellcare $18,484 144%
Care Wisconsin/Mychoice $18,665 146%
Centivo $37,942 - $44,075 296%
Medical College Of Wisconsin $39,015 305%
Froedtert South $40,979 320%
Sheboygan Employers Health Network $42,405 331%
Cigna $45,418 355%
Chorus Community Health Plan $48,368 378%
Wisconsin Physician Services Statewide Alliance $48,551 379%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9200 W Wisconsin Ave, Milwaukee, WI 53226
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals