CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Banner Heart Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $14,107
Cash Discount Price: $20,001
vs. Medicare Baseline: 1.10x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Banner Heart Hospital is $14,107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20,001. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.10x the Medicare baseline. Located in 6750 East Baywood Avenue, Mesa, AZ.

Cash / Self-Pay

$20,001

Average discount available for prompt cash payment at this facility.

Insurance Median

$14,107

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: $20,001 (156%)

Insurance Median: $14,107 (110%)

Cash: $20,001 (156% of Medicare)

Ins. Median: $14,107 (110% 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	$13,435 - $48,159	105%
Arizona Physicians Ipa	$13,435	105%
Banner Health	$13,435	105%
Banner University Health Plan	$13,435	105%
Blue Cross Blue Shield	$13,435 - $77,222	105%
Care 1St	$13,435	105%
Cigna	$13,435 - $54,755	105%
Gila River Health Care Corporation	$13,435	105%
Health Choice Arizona, Inc.	$13,435 - $20,153	105%
Health Net	$13,435 - $19,884	105%
Humana	$13,435 - $13,838	105%
Kaiser Foundation Health Plan	$13,435	105%
Mercy Care	$13,435	105%
Triwest Healthcare Alliance Corp - Va Ccn	$13,435	105%
UnitedHealthcare	$13,435 - $47,976	105%
Upmc Health Plan	$13,435	105%
Wellpoint	$13,435	105%
Carelon	$14,107	110%
Devoted Health Services	$14,107	110%
Arizona Priority Care	$14,779	115%
Gold Kidney Health Plan	$14,779	115%
Oscar Health Plan	$22,168	173%

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 $20,001.
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 Heart Hospital 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.