CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Adventist Health Lodi Memorial

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $21,380
Cash Discount Price: $10,300
vs. Medicare Baseline: 1.67x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Adventist Health Lodi Memorial is $21,380. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,300. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.67x the Medicare baseline. Located in 975 S Fairmont Avenue, Lodi, CA.

Cash / Self-Pay

$10,300

Average discount available for prompt cash payment at this facility.

Insurance Median

$21,380

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: $10,300 (80%)

Insurance Median: $21,380 (167%)

Cash: $10,300 (80% of Medicare)

Ins. Median: $21,380 (167% 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
Networks By Design- All Plans	$1,677	13%
Western Growers- All Plans	$2,622	20%
Celtic Ins Company - All Plans	$8,616	67%
UnitedHealthcare	$11,829 - $31,714	92%
Blue Cross Blue Shield	$15,166 - $17,026	118%
Alignment Health Plan (Ahp)-All Plans	$17,511	137%
Blue Shield Mcare Adv	$17,511	137%
Healthnet Mcare	$17,511	137%
Hp Of San Joaquin Mcr Adv	$17,511	137%
Humana	$17,511	137%
Kaiser Mcr Adv	$17,511	137%
Tricare	$17,511	137%
Cca Health Plan Mcr Adv- All Plans	$17,862	139%
Knnex Health - All Plans	$21,014	164%
Kaiser Mcal	$21,380	167%
Medi-Cal	$21,380	167%
Hp Of San Joaquin Mcal	$23,734	185%
Aetna	$23,896	187%
Bc Mcal	$25,205	197%
Healthnet- All Other Plans	$26,054	203%
Ah Employee Health Plan - All Plans	$31,520	246%
Bright Health - All Plans	$31,822	248%
Blue Shield Epn - All Other Plans	$42,082	329%
Blue Shield Non-Epn	$43,554	340%
Kaiser Commercial - All Other Plans	$60,328	471%
Cigna	$65,047	508%
First Health- All Plans	$110,355	862%
Multiplan- All Plans	$117,712	919%
Beech Street- All Plans	$132,427	1034%
Three Rivers Provider Network- All Plans	$132,427	1034%

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 $10,300.
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 Adventist Health Lodi Memorial 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.