CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Providence Santa Rosa Memorial Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $19,903
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.55x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Providence Santa Rosa Memorial Hospital is $19,903. 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 1.55x the Medicare baseline. Located in 1165 Montgomery Dr, Santa Rosa, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$19,903

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: $19,903 (155%)
Ins. Median: $19,903 (155% 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.

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 $19,505 - $49,669 152%
Aetna $19,903 - $59,530 155%
Blue Cross Blue Shield $19,903 155%
Blue Shield $19,903 155%
Brand New Day $19,903 155%
Caremore $19,903 155%
Central Health Plan $19,903 155%
Cigna $19,903 155%
Humana $19,903 155%
Kaiser $19,903 155%
Providence Health Plan $19,903 155%
Scan Health Plan $19,903 155%
UnitedHealthcare $19,903 - $43,446 155%
Western Health Advantage $19,903 155%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1165 Montgomery Dr, Santa Rosa, CA 95405
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals