CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Saint Mary's Regional Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $20,085
Cash Discount Price: $14,877
vs. Medicare Baseline: 1.57x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Saint Mary's Regional Medical Center is $20,085. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14,877. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.57x the Medicare baseline. Located in 235 W 6Th St, Reno, NV.

Cash / Self-Pay

$14,877

Average discount available for prompt cash payment at this facility.

Insurance Median

$20,085

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: $14,877 (116%)

Insurance Median: $20,085 (157%)

Cash: $14,877 (116% of Medicare)

Ins. Median: $20,085 (157% 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)	$14,877 - $14,878	116%
Tricare	$14,877 - $25,242	116%
Aetna	$14,878	116%
Blue Cross Blue Shield	$14,878	116%
Health Plan Of Nevada	$14,878	116%
Molina Healthcare Of Nv	$14,878	116%
Saint Mary Health Plan	$14,878 - $17,109	116%
Sierra	$14,878	116%
Silver Summit	$14,878 - $23,060	116%
Triwest	$14,878	116%
Alignment	$15,175	118%
UnitedHealthcare	$15,324	120%
Pam	$17,109	134%
Employer Direct	$19,341	151%
Home Town Test	$20,828	163%
Naphcare	$20,828	163%
Asserta Health	$22,316	174%
Imperial Insurance Company	$22,316 - $27,523	174%
Occunet	$22,316	174%
Nevada Health Partners	$23,581	184%
National Healthcare Solutions, Inc	$23,804	186%
Nv Preferred	$24,814 - $31,494	194%
Custom Ink	$24,845	194%
6 Degrees	$26,482	207%

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 $14,877.
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 Saint Mary's Regional 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.