CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Southern Regional Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $19,108
  • Cash Discount Price: $18,538
  • vs. Medicare Baseline: 1.49x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Southern Regional Medical Center is $19,108. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18,538. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.49x the Medicare baseline. Located in 11 Upper Riverdale Road, Sw, Riverdale, GA.
Cash / Self-Pay
$18,538

Average discount available for prompt cash payment at this facility.

Insurance Median
$19,108

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: $18,538 (145%)
Insurance Median: $19,108 (149%)
Cash: $18,538 (145% of Medicare)
Ins. Median: $19,108 (149% 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.

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
Humana $10,330 - $22,423 81%
Corvel $16,810 131%
Novanet $16,810 131%
Americas Choice Provider Network $17,164 134%
Multiplan $17,164 134%
Prime Health Services $17,164 134%
Three Rivers $17,164 134%
Peach State $17,426 - $19,122 136%
Provider Select $17,518 137%
Georgia Workers’ Compensation $17,695 138%
UnitedHealthcare $18,206 - $18,565 142%
Clear Spring Health Plan $18,539 145%
Medicare (plans) $18,539 145%
Riverwood Behavioral Health $18,539 - $18,565 145%
Aetna $18,565 - $23,811 145%
Blue Cross Blue Shield $18,565 - $22,628 145%
Cigna $18,565 - $26,877 145%
Devoted Health $19,095 149%
Caresource $19,122 - $32,443 149%
Wellcare $19,122 149%
Sonder Health Plan $19,493 152%
Tricare $22,151 173%
Employer Direct Healthcare $24,100 188%
Oscar Health Plan $24,100 188%
Centurion $27,808 217%
Naphcare $28,735 224%
National Healthcare Solutions, Inc. $29,662 232%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 11 Upper Riverdale Road, Sw, Riverdale, GA 30274
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals