CMS Price Transparency Data
Heart stent placement (inpatient stay)
Facility: San Antonio Regional Hospital
Billing Code: 322 (MS-DRG)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 322
- Insurance Median: $21,125
- Cash Discount Price: $215,113
- vs. Medicare Baseline: 1.65x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at San Antonio Regional Hospital is $21,125. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $215,113. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.65x the Medicare baseline. Located in 999 San Bernardino Road, Upland, CA.
Cash / Self-Pay
$215,113
Average discount available for prompt cash payment at this facility.
Insurance Median
$21,125
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: $215,113 (1680%)
Insurance Median: $21,125 (165%)
Cash: $215,113 (1680% of Medicare)
Ins. Median: $21,125 (165% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| San Bernardino Cnty Ip Only-All Plans | $3,750 | 29% |
| Foundation Inland Ppo | $9,607 | 75% |
| Foundation Inland Epo-All Other Plans | $11,605 | 91% |
| Heritage Prov Ntwrk/Regal - All Other Plans | $13,909 | 109% |
| Cigna | $15,315 | 120% |
| Choicecare Ntwrk-All Plans | $15,860 | 124% |
| Pc Inland Valley Scan | $17,092 | 133% |
| Pc Inland Valley-All Other Plans | $17,092 | 133% |
| Tricare | $17,135 | 134% |
| Aetna | $17,485 - $23,605 | 137% |
| Alpha Care Mg Mcr Adv | $17,485 | 137% |
| Blue Shield Mcr Adv | $17,485 | 137% |
| Caremore Mcr Adv - All Plans | $17,485 | 137% |
| Central Hlth Plan Mcr Adv-All Plans | $17,485 | 137% |
| Choice Phycn Ntwrk Mcr Adv-All Other Plans | $17,485 | 137% |
| Epic Health Plan Mcr Adv | $17,485 | 137% |
| Healthnet Mcr Adv | $17,485 | 137% |
| Humana | $17,485 | 137% |
| Iehp Mcr Adv | $17,485 | 137% |
| Imperial Health Mcr Adv-All Plans | $17,485 | 137% |
| Inter Valley Hp Mcr Adv- All Plans | $17,485 | 137% |
| Kindred Mcr Adv-All Plans | $17,485 | 137% |
| Molina Mcr Adv | $17,485 | 137% |
| Prospect Hp-All Plans | $17,485 | 137% |
| Providence Clevercare Mcr Adv | $17,485 | 137% |
| Scan Health Plan Mcr Adv-All Plans | $17,485 | 137% |
| Universal Care - All Plans | $17,485 | 137% |
| Heritage Prov Ntwrk/Regal Mcr Adv | $17,747 | 139% |
| Blue Cross Blue Shield | $17,835 - $34,110 | 139% |
| Wellcare/Easy Choice-All Plans | $17,835 | 139% |
| Clever Care Mcr Adv - All Plans | $18,359 | 143% |
| La Salle Hp Mcr Adv-All Plans | $18,359 | 143% |
| Zelis Mcr Adv | $18,359 | 143% |
| Kasiser Mcr Adv | $18,709 | 146% |
| Blue Shield Epn | $20,532 | 160% |
| Alpha Care Mg-All Other Plans | $21,856 | 171% |
| Molina Exchange-All Other Plans | $22,730 | 177% |
| Iehp Comm - All Other Plans | $25,353 | 198% |
| Providence Oscar-All Other Plans | $25,353 | 198% |
| Redlands Employee | $26,227 | 205% |
| Medi-Cal | $26,826 | 209% |
| Redlands Hmo-All Other Plans | $27,276 | 213% |
| Healthnet - All Other Plans | $27,469 | 214% |
| Kaiser Medi-Cal | $28,167 | 220% |
| UnitedHealthcare | $28,220 - $36,354 | 220% |
| Healthnet Medi-Cal | $28,301 | 221% |
| Molina Medi-Cal | $29,240 | 228% |
| Alpha Care Mg Mcal/Hlthy Kids | $29,508 | 230% |
| Heritage Prov Ntwrk/Regal Mcal | $29,508 | 230% |
| Prime Health - All Plans | $30,598 | 239% |
| Ambetter / Centene | $30,931 | 242% |
| Iehp Mcal | $31,118 | 243% |
| Coventry Ccn/First Hlth - All Plans | $43,251 | 338% |
| Kaiser Comm - All Other Plans | $48,783 | 381% |
| Blue Shield Hmo Pos / Calpers Ppo | $53,865 | 421% |
| Blue Shield Epo Ppo - All Other Plans | $55,265 | 432% |
| Epic Health Plan - All Other Plans | $63,268 | 494% |
| Networks By Design - All Plans | $66,421 | 519% |
| Multiplan/Phcs - All Plans | $153,677 | 1200% |
| Zelis Comm-All Other Plans | $158,171 | 1235% |
| Interplan - All Plans | $168,716 | 1317% |
| Health Payors - All Plans | $179,261 | 1400% |