CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Bay Area Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $31,734
Cash Discount Price: $38,896
vs. Medicare Baseline: 2.48x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Bay Area Hospital is $31,734. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38,896. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 2.48x the Medicare baseline. Located in 1775 Thompson Road, Coos Bay, OR.

Cash / Self-Pay

$38,896

Average discount available for prompt cash payment at this facility.

Insurance Median

$31,734

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: $38,896 (304%)

Insurance Median: $31,734 (248%)

Cash: $38,896 (304% of Medicare)

Ins. Median: $31,734 (248% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 248% of the Medicare baseline (a markup of 148%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Healthnet Mcaid	$11,824	92%
Southwest Oregon Ipa - All Plans	$12,268	96%
Healthnet Mcr Adv	$15,963	125%
Moda Hlth Mcr Adv	$17,242	135%
Moda Beacon - All Other Plans	$25,313	198%
Ods Ppo/Pos - All Plans	$28,208	220%
Nasomah Hlth Grp - All Plans	$31,117	243%
Providence - All Other Plans	$31,734	248%
Providence Pebb	$31,734	248%
Blue Cross Blue Shield	$35,084	274%
Pacificsource - All Plans	$44,083	344%
Moda Connexus/Synergy	$46,307	362%
First Choice - All Plans	$47,138	368%
Aetna	$47,713	373%
Cigna	$47,713	373%
Healthnet Comm- All Other Plans	$49,269	385%
UnitedHealthcare	$49,269	385%

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 $38,896.
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 Bay Area 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.