CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Saint Anthony Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $17,334
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.35x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Saint Anthony Medical Center is $17,334. 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 1.35x the Medicare baseline. Located in 5666 East State Street, Rockford, IL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$17,334

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: $17,334 (135%)

Ins. Median: $17,334 (135% 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
Phcs	$13,222	103%
Health Alliance Plan	$14,389	112%
Humana	$14,389 - $28,996	112%
Meridian	$14,389	112%
Molina Healthcare	$14,389	112%
UnitedHealthcare	$14,389 - $30,689	112%
Aetna	$14,533 - $19,559	113%
Wellcare	$14,533	113%
Blue Cross Blue Shield	$14,677 - $24,536	115%
Zing	$15,109	118%
Caterpillar	$24,151	189%
Dean Health Plan	$25,715	201%
Cigna	$30,801	240%
Osfdan	$31,636	247%
The Alliance	$31,636	247%

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 Saint Anthony 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.