CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Central Maine Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $17,032
Cash Discount Price: $14,456
vs. Medicare Baseline: 1.33x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Central Maine Medical Center is $17,032. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14,456. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.33x the Medicare baseline. Located in 300 Main Street, Lewiston, ME.

Cash / Self-Pay

$14,456

Average discount available for prompt cash payment at this facility.

Insurance Median

$17,032

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: $14,456 (113%)

Insurance Median: $17,032 (133%)

Cash: $14,456 (113% of Medicare)

Ins. Median: $17,032 (133% 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
Medicaid / KanCare	$12,522	98%
Aetna	$13,914 - $49,889	109%
Blue Cross Blue Shield	$13,914 - $31,857	109%
Humana	$13,914	109%
UnitedHealthcare	$13,914 - $55,418	109%
Wellcare	$13,914	109%
Medicare (plans)	$14,456	113%
Self-Pay	$14,456	113%
Workers Compensation	$19,608	153%
Martins Point	$45,757	357%
Tricare	$45,757	357%
Cigna	$47,157	368%
Community Health Options	$48,472	378%
Harvard Pilgrim	$48,625	380%

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 $14,456.
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 Central Maine 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.