CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Garden Grove Hospital & Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $17,064
Cash Discount Price: $16,979
vs. Medicare Baseline: 1.33x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Garden Grove Hospital & Medical Center is $17,064. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16,979. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.33x the Medicare baseline. Located in 12601 Garden Grove Blvd, Garden Grove, CA.

Cash / Self-Pay

$16,979

Average discount available for prompt cash payment at this facility.

Insurance Median

$17,064

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: $16,979 (133%)

Insurance Median: $17,064 (133%)

Cash: $16,979 (133% of Medicare)

Ins. Median: $17,064 (133% 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
Blue Shield Of Ca	$16,979	133%
Central Health Plan	$16,979	133%
Health Net Of Ca	$16,979 - $30,767	133%
Innovative Mgmt Svcs	$16,979	133%
Medcare Partners Health Plan	$16,979	133%
Medicare (plans)	$16,979	133%
Molina	$16,979	133%
Patient Choice Health Plan	$16,979	133%
Renal Payer Solutions	$16,979	133%
Verda Healthplan	$16,979	133%
Brand New Day	$17,149	134%
Imperial Health Plan Of Ca	$17,998	141%
Employer Direct Healthcare	$22,073	172%
Aetna	$26,153	204%
Naphcare	$26,318	205%
National Healthcare Solutions, Inc (Nhsi)	$27,167	212%
Tricare	$29,038	227%
Workers Compensation	$33,517	262%

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 $16,979.
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 Garden Grove Hospital & 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.