CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Piedmont Augusta Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $23,901
Cash Discount Price: $29,404
vs. Medicare Baseline: 1.87x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Piedmont Augusta Hospital is $23,901. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $29,404. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.87x the Medicare baseline. Located in 1350 Walton Way, Augusta, GA.

Cash / Self-Pay

$29,404

Average discount available for prompt cash payment at this facility.

Insurance Median

$23,901

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: $29,404 (230%)

Insurance Median: $23,901 (187%)

Cash: $29,404 (230% of Medicare)

Ins. Median: $23,901 (187% 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
Medicare (plans)	$12,726 - $13,220	99%
UnitedHealthcare	$12,911 - $39,837	101%
Clear Spring Health Care [30192]	$13,096	102%
Georgia Health Advantage [30143]	$13,343	104%
Blue Cross Blue Shield	$17,416 - $41,755	136%
Ambetter / Centene	$21,909	171%
Aetna	$26,221	205%
Caresource Marketplace [11106]	$26,610	208%
First Health [10303]	$37,358	292%
Cigna	$39,787	311%

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 $29,404.
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 Piedmont Augusta 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.