CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Montclair Hospital Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $17,613
Cash Discount Price: $17,613
vs. Medicare Baseline: 1.38x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Montclair Hospital Medical Center is $17,613. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17,613. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.38x the Medicare baseline. Located in 5000 San Bernardino Road, Montclair, CA.

Cash / Self-Pay

$17,613

Average discount available for prompt cash payment at this facility.

Insurance Median

$17,613

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: $17,613 (138%)

Insurance Median: $17,613 (138%)

Cash: $17,613 (138% of Medicare)

Ins. Median: $17,613 (138% 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
Alignment	$17,504	137%
Central Health Plan	$17,504	137%
Choice Physicians Network	$17,504	137%
Elite Health Plan	$17,504	137%
Emanate Health	$17,504 - $35,227	137%
Epic Health Plan	$17,504 - $24,659	137%
Health Net Of Ca	$17,504 - $31,915	137%
Inland Empire Healthplan	$17,504 - $22,017	137%
Medicare (plans)	$17,504 - $17,613	137%
Molina	$17,504 - $17,613	137%
Renal Payor Solution	$17,504	137%
Vantage Care	$17,504	137%
Inland Empire Foundation For Medical Care	$17,613	138%
Tricare	$17,613 - $30,040	138%
Brand New Day	$17,679	138%
Neighborhood	$17,854	139%
Imperial Health Plan Of Ca	$18,554	145%
Health Net Federal Services Prison (Cdcr)	$22,017	172%
Employer Direct Health Care	$22,897	179%
Coventry Workers Compensation	$26,677	208%
National Healthcare Solutions, Inc (Nhsi)	$28,181	220%
Worker Compensation	$32,465	253%

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 $17,613.
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 Montclair 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.