CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Good Samaritan Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $19,695
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.54x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Good Samaritan Hospital is $19,695. 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 1.54x the Medicare baseline. Located in 2425 Samaritan Drive, San Jose, CA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$19,695

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: $19,695 (154%)

Ins. Median: $19,695 (154% 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
First Health	$3,183 - $5,426	25%
Healthsmart	$3,789	30%
Multiplan	$4,183	33%
Health Net	$4,316 - $8,580	34%
Cigna	$6,671 - $41,358	52%
Aetna	$8,355 - $103,673	65%
United	$10,135 - $104,939	79%
Blue Shield	$15,300 - $20,089	119%
Vitas Healthcare Hospice	$17,726	138%
Vitality Health Plan	$19,104	149%
Affinity Medical Group	$19,695	154%
Alignment Health Plan	$19,695	154%
Blue Cross Blue Shield	$19,695	154%
Central Health Plan	$19,695	154%
Clever Care Of Golden State	$19,695 - $20,680	154%
Easy Choice Health Plan	$19,695	154%
Humana	$19,695	154%
Medcare Partners	$19,695 - $20,680	154%
On Lok Senior Health	$19,695	154%
Palo Alto Medical	$19,695 - $25,604	154%
Santa Clara Family Health Plan	$19,695	154%
Scan Health Plan	$19,695	154%
Triwest Healthcare Alliance	$19,695	154%
University Healthcare	$19,695	154%
Care1St Health Plan	$20,089	157%
Affinity Medical Group Comm	$25,604	200%
Corvel Corporation	$30,422	238%

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 $X.
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 Good Samaritan Hospital 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.