CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Lowell General Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $15,845
Cash Discount Price: $33,140
vs. Medicare Baseline: 1.24x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Lowell General Hospital is $15,845. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $33,140. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.24x the Medicare baseline. Located in 295 Varnum Avenue, Lowell, MA.

Cash / Self-Pay

$33,140

Average discount available for prompt cash payment at this facility.

Insurance Median

$15,845

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: $33,140 (259%)

Insurance Median: $15,845 (124%)

Cash: $33,140 (259% of Medicare)

Ins. Median: $15,845 (124% 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
Medicare (plans)	$1,971 - $16,152	15%
Aetna	$4,540 - $15,845	35%
Meritain [100063]	$4,540	35%
Elementcare [450046]	$6,359	50%
Tufts Health Public Plan Connectorcare [100264]	$8,641 - $11,478	67%
Champva [800006]	$15,426	120%
UnitedHealthcare	$15,426 - $16,152	120%
Veterans Services [800005]	$15,426	120%
Cigna	$15,845	124%
Fallon Senior [450065]	$15,845 - $16,152	124%
Harvard Pilgrim Stride [450060]	$15,845	124%
Humana	$15,845	124%
Martins Point Generations Replacement [450057]	$15,845	124%
Medicaid / KanCare	$15,845 - $26,361	124%
Neighborhood Pace [450114]	$15,845	124%
Peak Pace Solutions [450115]	$15,845	124%
Secure Horizons Ma Pffs [450077]	$15,845	124%
Veterans Evaluation Svcs [800004]	$15,845	124%
Blue Cross Blue Shield	$16,152 - $48,043	126%
Commonwealth Care Alliance [450067]	$16,152	126%
Wellpoint [100139]	$21,986	172%
Fallon Health Connectorcare [100260]	$25,197	197%
Fallon Health [100259]	$25,197	197%
Generic Prison [500099]	$26,361	206%
Middlesex County [500015]	$26,361	206%
Suffolk County [500014]	$26,361	206%
Tewksbury Hospital [950008]	$26,361	206%
Tufts Health Public Plan [350009]	$26,429	206%
Wellsense Clarity Connectorcare [100256]	$34,269 - $39,805	268%
Blue Benefits Administrators [100267]	$42,993 - $46,681	336%
Health Safety Net [500011]	$72,614	567%

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 $33,140.
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 Lowell General 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.