CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Banner Boswell Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $14,602
Cash Discount Price: $19,019
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Banner Boswell Medical Center is $14,602. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19,019. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.14x the Medicare baseline. Located in 13632 N 99Th Ave, Sun City, AZ.

Cash / Self-Pay

$19,019

Average discount available for prompt cash payment at this facility.

Insurance Median

$14,602

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%)

Cash / Self-Pay: $19,019 (149%)

Insurance Median: $14,602 (114%)

Cash: $19,019 (149% of Medicare)

Ins. Median: $14,602 (114% 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
Aetna	$13,907 - $45,847	109%
Arizona Physicians Ipa	$13,907	109%
Banner Health	$13,907	109%
Banner University Health Plan	$13,907	109%
Blue Cross Blue Shield	$13,907 - $79,028	109%
Care 1St	$13,907	109%
Cigna	$13,907 - $54,755	109%
Gila River Health Care Corporation	$13,907	109%
Health Choice Arizona, Inc.	$13,907 - $20,860	109%
Health Net	$13,907 - $20,582	109%
Humana	$13,907 - $14,324	109%
Kaiser Foundation Health Plan	$13,907	109%
Mercy Care	$13,907	109%
Triwest Healthcare Alliance Corp - Va Ccn	$13,907	109%
UnitedHealthcare	$13,907 - $47,976	109%
Upmc Health Plan	$13,907	109%
Wellpoint	$13,907	109%
Carelon	$14,602	114%
Devoted Health Services	$14,602	114%
Arizona Priority Care	$15,298	119%
Gold Kidney Health Plan	$15,298	119%
Oscar Health Plan	$22,947	179%

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 $19,019.
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 Banner Boswell 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.