CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: T J Samson Community Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $13,663
Cash Discount Price: $17,711
vs. Medicare Baseline: 1.07x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at T J Samson Community Hospital is $13,663. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17,711. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.07x the Medicare baseline. Located in 1301 North Race Street, Glasgow, KY.

Cash / Self-Pay

$17,711

Average discount available for prompt cash payment at this facility.

Insurance Median

$13,663

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: $17,711 (138%)

Insurance Median: $13,663 (107%)

Cash: $17,711 (138% of Medicare)

Ins. Median: $13,663 (107% 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	$10,550 - $26,376	82%
Aetna	$12,170	95%
Humana	$12,810 - $13,165	100%
Wellcare Mcaid	$12,810	100%
Wellcare Mcr Adv - All Other Plans	$13,165	103%
Molina Mcaid	$13,195	103%
Signature Health - All Plans	$13,297	104%
Molina Mcr Adv	$13,429	105%
UnitedHealthcare	$13,503	105%
Devoted Mcr Adv - All Plans	$13,824	108%
Caresource - All Plans	$19,748	154%
Molina Marketplace - All Other Plans	$20,406	159%
Center Care Select - All Plans	$23,160	181%
Phcs/Multiplan - All Plans	$25,613	200%
First Health - All Plans	$25,885	202%

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 $17,711.
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 T J Samson Community 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.