Heart stent placement (inpatient stay)
Facility: Oakleaf Surgical Hospital
Billing Code: 322 (MS-DRG)
- CPT Billing Code: 322
- Insurance Median: $12,485
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.97x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
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 | $12,485 | 97% |
| Dean Health Plan | $12,485 | 97% |
| Group Health Cooperative Of Eau Claire | $12,485 | 97% |
| Healthpartners | $12,485 | 97% |
| Humana | $12,485 | 97% |
| Medica | $12,485 | 97% |
| Quartz Health Solutions | $12,485 | 97% |
| Security Health Plan Of Wi | $12,485 | 97% |
| Ucare Wi | $12,485 | 97% |
| UnitedHealthcare | $12,485 | 97% |
Consumer Guidance & Cost Commentary
For Heart stent placement (inpatient stay) at Oakleaf Surgical Hospital in Altoona, WI, the median negotiated rate is $12,485. This rate is consistent across all ten payers listed, including Blue Cross Blue Shield, Humana, and UnitedHealthcare, with both high and low values fixed at $12,485. The facility's Medicare amount is $12,807.10, which serves as the benchmark for evaluating pricing fairness. While specific county or state average data was not provided in the source material for direct comparison, the fixed negotiated rate of $12,485 represents the standard amount commercial insurers will pay for this procedure at this location.
Patients should note that the cash median rate is not available in the current data, but it is important to inquire about self-pay or prompt-pay discounts before scheduling, as these upfront payment incentives can significantly reduce costs for those without insurance or with high-deductible plans. Additionally, while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, patients should request an itemized billing audit to ensure no unexpected ancillary charges are included. Always verify your specific plan's deductible status and ask the hospital to classify the account as self-pay to secure the lowest possible rate before treatment.