CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Memorialcare Orange Coast Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $24,160
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.89x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Memorialcare Orange Coast Medical Center is $24,160. 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 1.89x the Medicare baseline. Located in 9920 Talbert Avenue, Fountain Valley, CA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$24,160

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: $24,160 (189%)

Ins. Median: $24,160 (189% 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
Monarch Health Plan	$16,756 - $37,745	131%
Blue Shield	$17,285 - $33,862	135%
Blue Cross Blue Shield	$17,638 - $42,659	138%
Citizens Choice	$17,638	138%
Healthcare Partners	$17,638 - $43,565	138%
Healthnet	$17,638 - $49,470	138%
Heritage Provider Network	$17,638	138%
Humana	$17,638	138%
La Care	$17,638	138%
Onecare	$17,638	138%
UnitedHealthcare	$17,638 - $52,782	138%
Wellcare	$17,638	138%
Molina	$18,167	142%
Clever Care	$18,520	145%
Universal Care	$18,520	145%
Central Health	$19,402	151%
Select Health	$23,811	186%
Aetna	$26,192 - $51,579	205%
Cigna	$35,721 - $56,151	279%
Centivo	$39,685	310%

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 Memorialcare Orange Coast 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.