CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Northside Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $20,802
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.62x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Northside Hospital is $20,802. 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 1.62x the Medicare baseline. Located in 1000 Johnson Ferry Road, Ne, Atlanta, GA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$20,802

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: $20,802 (162%)

Ins. Median: $20,802 (162% 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
Blue Cross Blue Shield	$3,245 - $20,802	25%
Kaiser	$3,538 - $26,989	28%
Aetna	$3,841 - $28,535	30%
Phcs	$4,403	34%
UnitedHealthcare	$5,000 - $29,752	39%
Cigna	$6,294 - $21,426	49%
Georgia Reproductive Specialists	$7,034	55%
Genex/Priority Care Solutions	$14,256	111%
Streamline Imaging	$16,038	125%
Corvel Workers Comp	$16,929	132%
Employers Choice Network	$16,929	132%
Careiq	$17,584	137%
Dekalb_Department Of Health	$17,584	137%
Fifa	$17,584	137%
Rabun County Boc	$17,584	137%
Spreemo	$17,584	137%
Georgia Workers Compensation	$17,820	139%
One Call Diagnostics	$17,820	139%
Clear Springs Eon Health	$20,802	162%
Medicare (plans)	$20,802 - $25,430	162%
Va Ccn	$20,802	162%
Humana	$21,010	164%
Coventry	$21,218	166%
Wellcare	$21,426	167%
Amerigroup	$21,634	169%
Ambetter / Centene	$21,842	171%
Caresource	$21,842	171%
Clover Health	$21,842	171%
Pruitt Health Premier	$21,842	171%
Northside Health Network	$25,603	200%
Oscar	$25,679	201%
Us Dept Of Labor Wc	$29,549	231%

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 Northside 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.