Heart stent placement (inpatient stay)
Facility: Susan B Allen Memorial Hospital
Billing Code: 322 (MS-DRG)
- CPT Billing Code: 322
- Insurance Median: $757
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.06x 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 |
|---|---|---|
| Aetna | $19,277 | 151% |
Consumer Guidance & Cost Commentary
For the heart stent placement procedure at Susan B Allen Memorial Hospital in El Dorado, KS, the facility's negotiated rate is $757.00, which is significantly lower than the Aetna negotiated rate of $19,277.00 listed for this service. While the data indicates no specific cash or median paid values for this code, patients with high-deductible plans should be aware that paying cash upfront can sometimes result in lower out-of-pocket costs if the insurance negotiated rate exceeds the cash price. It is crucial to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront incentives can bypass the administrative overhead associated with insurance billing cycles.
This pricing analysis is based on the 2026-06 vintage data, where the Medicare benchmark amount for this service is $12,807.10. The facility's negotiated rate of $757.00 represents a substantial difference from the Medicare amount, illustrating the potential for significant savings when utilizing contracted insurance rates rather than standard billing lists. Patients should be cautious of balance billing, which occurs when providers bill the difference between their full charges and what insurance pays, though the No Surprises Act generally protects patients from such unexpected costs for emergency and non-emergency services at in-network facilities. To ensure accuracy, consumers should request a detailed, itemized bill to verify that all charges align with the negotiated rate and that no unbundled codes or services not rendered have been included.