CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Grandview Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $11,162
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.87x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Grandview Medical Center is $11,162. 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 0.87x the Medicare baseline. Located in 3690 Grandview Parkway, Birmingham, AL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$11,162

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: $11,162 (87%)

Ins. Median: $11,162 (87% 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
Healthchoice	$1,400 - $1,500	11%
Natl Comp Care	$2,802	22%
Coventry Work Comp Al	$3,033	24%
First Health	$3,033	24%
Novanet	$3,132	24%
UnitedHealthcare	$3,135 - $20,512	24%
Alabama Wc	$3,297	26%
Viva Health	$3,763 - $11,771	29%
Alamed	$4,392	34%
Multiplan	$8,623	67%
Healthspring	$9,079	71%
Blue Advantage	$11,162	87%
Humana	$11,748	92%
Victory Health	$11,748	92%
Medicare (plans)	$11,771 - $12,262	92%
Select Health	$11,888	93%
Cigna	$12,005 - $18,312	94%
Aetna	$12,123	95%
Node Wellcare Mcr Adv	$12,191	95%
Node Devoted Health Mcr Adv	$12,507	98%
Blue Cross Blue Shield	$12,566	98%
Node Clover Health Mcr Adv	$12,602	98%
Node Va	$12,726	99%
Choicecare	$14,986	117%
Ambetter / Centene	$16,974	133%
Node Us Dept Of Labor	$18,312	143%

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 Grandview Medical Center 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.