CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Sterling Regional Medcenter

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $21,660
Cash Discount Price: $23,648
vs. Medicare Baseline: 1.69x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Sterling Regional Medcenter is $21,660. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23,648. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.69x the Medicare baseline. Located in 615 Fairhurst St, Sterling, CO.

Cash / Self-Pay

$23,648

Average discount available for prompt cash payment at this facility.

Insurance Median

$21,660

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: $23,648 (185%)

Insurance Median: $21,660 (169%)

Cash: $23,648 (185% of Medicare)

Ins. Median: $21,660 (169% 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
Pinnacol Assurance Workers Comp	$15,956	125%
Aetna	$21,660	169%
Banner Health	$21,660	169%
Blue Cross Blue Shield	$21,660	169%
Clear Spring Health	$21,660	169%
Healthspring Life & Health Insurance Company, Inc.	$21,660	169%
Medica	$21,660	169%
Medicare (plans)	$21,660	169%
UnitedHealthcare	$21,660	169%
Longevity	$22,310	174%
Humana	$22,960	179%
Devoted Health Services	$23,826	186%
Denver Health Medical Plan	$42,304	330%

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 $23,648.
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 Sterling Regional Medcenter 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.