CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Garden City Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $13,823
Cash Discount Price: $16,076
vs. Medicare Baseline: 1.08x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Garden City Hospital is $13,823. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16,076. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.08x the Medicare baseline. Located in 6245 Inkster Rd, Garden City, MI.

Cash / Self-Pay

$16,076

Average discount available for prompt cash payment at this facility.

Insurance Median

$13,823

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: $16,076 (126%)

Insurance Median: $13,823 (108%)

Cash: $16,076 (126% of Medicare)

Ins. Median: $13,823 (108% 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	$13,486	105%
Blue Cross Blue Shield	$13,486 - $39,556	105%
Harbor Health Plan	$13,486	105%
Honest Hmo	$13,486	105%
Humana	$13,486	105%
Mclaren Health Plan	$13,486	105%
Medicare (plans)	$13,486 - $16,076	105%
Sunrise	$13,486	105%
Total Health Care Priority Health	$13,486	105%
United Behavioral Health	$13,486	105%
Zing	$14,161	111%
Longevity Hp	$14,295	112%
UnitedHealthcare	$16,076	126%
Employer Direct Healthcare	$20,899	163%
Naphcare Residential Inmate Treatment Center	$20,904	163%
Priority Health	$21,059	164%
National Healthcare Solutions, Inc	$25,722	201%
Tricare	$27,771	217%

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 $16,076.
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 Garden City 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.