CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: West Anaheim Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $18,132
Cash Discount Price: $18,012
vs. Medicare Baseline: 1.42x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at West Anaheim Medical Center is $18,132. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18,012. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.42x the Medicare baseline. Located in 3033 W Orange Avenue, Anaheim, CA.

Cash / Self-Pay

$18,012

Average discount available for prompt cash payment at this facility.

Insurance Median

$18,132

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: $18,012 (141%)

Insurance Median: $18,132 (142%)

Cash: $18,012 (141% of Medicare)

Ins. Median: $18,132 (142% 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 Cross Blue Shield	$17,217	134%
Central Health Plan	$17,217	134%
Health Net Of Ca	$17,217 - $32,639	134%
Health Net Of Ca Mhn (Bh)	$17,217	134%
Managed Health Network	$17,217	134%
Molina	$17,217 - $18,013	134%
Renal Payor Solutions	$17,217	134%
Verda Health Plan	$17,217	134%
Brand New Day	$17,389	136%
Blue Shield Of Ca Triwest	$18,013	141%
Medicare (plans)	$18,013	141%
Imperial Health Plan Of Ca Inc	$18,250	142%
Health Net Federal Services	$22,516	176%
Employer Direct Healthcare Surgery Plus	$23,417	183%
Naphcare (Santa Ana - County Jail)	$27,920	218%
Naphcare Residential Treatment Center	$27,920	218%
National Healthcare Solutions, Inc (Nhsi)	$28,820	225%
Tricare	$31,024	242%
Ca Foundation For Medical Care	$31,619	247%
Workers Compensation	$31,619	247%
Aetna	$32,943	257%

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 $18,012.
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 West Anaheim 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.