CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Saint Agnes Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $18,510
Cash Discount Price: $69,894
vs. Medicare Baseline: 1.45x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Saint Agnes Medical Center is $18,510. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69,894. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.45x the Medicare baseline. Located in 1303 E Herndon Ave, Fresno, CA.

Cash / Self-Pay

$69,894

Average discount available for prompt cash payment at this facility.

Insurance Median

$18,510

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: $69,894 (546%)

Insurance Median: $18,510 (145%)

Cash: $69,894 (546% of Medicare)

Ins. Median: $18,510 (145% 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
Healthnet	$6,538	51%
Coventry	$7,425	58%
Aetna	$7,613 - $17,612	59%
Meritain	$8,483	66%
Trustmark Small Business Benefits	$8,483	66%
Allied Benefit Systems	$8,956	70%
Boon Chapman	$8,956	70%
Hap	$8,956	70%
Webtpa	$8,956	70%
Advantek Central Usd	$10,873	85%
Blue Cross Blue Shield	$11,254 - $41,927	88%
Allegiance	$13,395	105%
American Postal Workers Secondary	$13,395	105%
Cigna	$13,395	105%
Medicare (plans)	$15,753 - $18,510	123%
Humana	$17,612 - $17,971	138%
UnitedHealthcare	$17,964 - $32,665	140%
Welbe Health	$20,582	161%
Align Senior Care	$20,667	161%
Kaiser Permanente	$31,449	246%
Geha	$32,665	255%
Blue Shield - Ca	$33,840 - $41,927	264%
Blue Benefit Administrators Of Massachusetts	$41,927	327%
Blue Care Network	$41,927	327%
Blue Distinction Transplant	$41,927	327%
Blue Shield - Id (Regence)	$41,927	327%
Blue Shield - Ny Highmark Northeastern	$41,927	327%
Blue Shield - Ny Highmark Western	$41,927	327%
Blue Shield - Pa (Highmark)	$41,927	327%
Blue Shield - Wa (Regence)	$41,927	327%

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 $69,894.
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 Saint Agnes 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.