CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Riverside Community Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $22,091
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.72x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Riverside Community Hospital is $22,091. 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 1.72x the Medicare baseline. Located in 4445 Magnolia Avenue, Riverside, CA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$22,091

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: $22,091 (172%)

Ins. Median: $22,091 (172% 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
Medi-Cal	$1,363	11%
Redlands Community	$3,350	26%
First Health	$3,407	27%
Health Net	$4,472 - $8,580	35%
Cigna	$5,314 - $59,871	41%
Blue Shield	$5,666 - $9,137	44%
United	$7,920 - $70,529	62%
Vitas Healthcare Hospice	$15,464	121%
Bristol Hospice	$17,673	138%
Brand New Day	$21,649 - $33,137	169%
Aetna	$22,091 - $98,084	172%
Alignment Health Plan	$22,091	172%
Blue Cross Blue Shield	$22,091	172%
Central Health Plan	$22,091	172%
Clever Care Of Golden State	$22,091 - $23,196	172%
Easy Choice Health Plan	$22,091	172%
Heritage Provider Network	$22,091 - $31,148	172%
Humana	$22,091	172%
Medcare Partners	$22,091 - $23,196	172%
Redlands Community Hospital	$22,091	172%
Riverside Physician	$22,091	172%
Scan Health Plan	$22,091	172%
Triwest Healthcare Alliance	$22,091	172%
UnitedHealthcare	$22,091	172%
Care1St Health Plan	$22,533	176%
Corvel Corporation	$34,327	268%
Healthsmart	$34,674	271%
Next	$34,674	271%
Inland Empire Health Plan	$39,764	310%

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 Riverside Community 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.