CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Piedmont Cartersville Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $25,972
Cash Discount Price: $42,418
vs. Medicare Baseline: 2.03x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Piedmont Cartersville Medical Center is $25,972. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42,418. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 2.03x the Medicare baseline. Located in 960 Joe Frank Harris Parkway, Cartersville, GA.

Cash / Self-Pay

$42,418

Average discount available for prompt cash payment at this facility.

Insurance Median

$25,972

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: $42,418 (331%)

Insurance Median: $25,972 (203%)

Cash: $42,418 (331% of Medicare)

Ins. Median: $25,972 (203% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 203% of the Medicare baseline (a markup of 103%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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)	$15,528 - $16,131	121%
UnitedHealthcare	$15,754 - $39,479	123%
Clear Spring Health Care [30192]	$15,980	125%
Georgia Health Advantage [30143]	$16,131	126%
Blue Cross Blue Shield	$23,443 - $49,123	183%
Ambetter / Centene	$25,972	203%
Aetna	$26,221	205%
Cigna	$28,210 - $41,882	220%
Alliant Solocare [11101]	$30,850	241%
Caresource Marketplace [11106]	$32,574	254%
Alliant Health Plans Of Georgia [10952]	$34,997	273%

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 $42,418.
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 Cartersville 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.