CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Lower Bucks Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $16,303
Cash Discount Price: $15,828
vs. Medicare Baseline: 1.27x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Lower Bucks Hospital is $16,303. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15,828. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.27x the Medicare baseline. Located in 501 Bath Road, Bristol, PA.

Cash / Self-Pay

$15,828

Average discount available for prompt cash payment at this facility.

Insurance Median

$16,303

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: $15,828 (124%)

Insurance Median: $16,303 (127%)

Cash: $15,828 (124% of Medicare)

Ins. Median: $16,303 (127% 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
Worker Compensation	$6,016	47%
Keenan	$9,000	70%
Blue Cross Blue Shield	$14,285	112%
Health Partners Plan	$14,285 - $21,791	112%
Pa Health & Wellness	$14,285 - $18,994	112%
UnitedHealthcare	$14,285 - $22,656	112%
Keystone	$14,857	116%
Medicare (plans)	$15,000 - $15,829	117%
Provider Patners Health Plan	$16,303	127%
Spartan Plan Pa	$16,620	130%
Auto Insurance	$17,411	136%
Humana	$19,481	152%
Employer Direct Healthcare	$20,577	161%
Cigna	$23,092	180%
Tricare	$26,191	205%
Highmark	$29,974	234%

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 $15,828.
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 Lower Bucks 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.