CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Anderson Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $14,116
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.10x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Anderson Hospital is $14,116. 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 1.10x the Medicare baseline. Located in 6800 State Route 162, Maryville, IL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$14,116

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: $14,116 (110%)

Ins. Median: $14,116 (110% 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
Health Care Service Corporation	$2,228 - $2,495	17%
Healthlink	$2,329 - $2,459	18%
Blue Cross Blue Shield	$3,604	28%
Self Pay	$8,792	69%
Aetna	$13,002 - $14,116	102%
Mercy Benefit Admin	$13,801	108%
Mercy Aco	$13,928	109%
Humana	$14,116	110%
Medicare (plans)	$14,116	110%
UnitedHealthcare	$14,116 - $15,543	110%
Essence	$14,368 - $14,799	112%
Devoted Health Ppo	$14,398	112%
Cigna	$14,402	112%
Clear Springs Health	$14,539	114%
Ambetter / Centene	$15,867	124%
Blue Choice	$20,834	163%
Hopetrust	$35,920	280%

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 Anderson 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.