CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Monroe Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $19,333
Cash Discount Price: $13,809
vs. Medicare Baseline: 1.51x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Monroe Hospital is $19,333. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13,809. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.51x the Medicare baseline. Located in 4011 S Monroe Medical Park Blvd, Bloomington, IN.

Cash / Self-Pay

$13,809

Average discount available for prompt cash payment at this facility.

Insurance Median

$19,333

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: $13,809 (108%)

Insurance Median: $19,333 (151%)

Cash: $13,809 (108% of Medicare)

Ins. Median: $19,333 (151% 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
Aetna	$13,809	108%
Blue Cross Blue Shield	$13,809 - $24,856	108%
Care Source	$13,809 - $20,023	108%
Medicare (plans)	$13,809	108%
UnitedHealthcare	$13,809 - $24,606	108%
Usa Senior Care Network	$13,809	108%
Worthington Christian Fellowship	$13,809	108%
Monroe Medical Group And Managed Health Services	$14,085 - $18,642	110%
Southeastern Indiana Health Operations	$14,638 - $15,614	114%
Provider Partners Health Plan	$15,190	119%
Employer Direct Healthcare	$17,952	140%
Independent Medical Solutions (Ims) Commercial	$22,095	173%
Tricare	$23,799	186%
Corvel Workers Compensation	$24,028	188%
Zelis Healthcare Fka Stratose	$26,237	205%
Americas Choice Provider Network Acpn	$26,790	209%
Multiplan	$26,790	209%
Prime Health Services	$26,790	209%
Three Rivers	$26,790	209%
Encore Health Network Workers Compensation	$27,066	211%
Provider Select	$27,342	213%
Provider Network Of America	$27,618	216%
Workers Compensation	$27,618	216%

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 $13,809.
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 Monroe 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.