CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Conemaugh Memorial Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $16,577
Cash Discount Price: $25,998
vs. Medicare Baseline: 1.29x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Conemaugh Memorial Medical Center is $16,577. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25,998. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.29x the Medicare baseline. Located in 1086 Franklin Street, Johnstown, PA.

Cash / Self-Pay

$25,998

Average discount available for prompt cash payment at this facility.

Insurance Median

$16,577

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: $25,998 (203%)

Insurance Median: $16,577 (129%)

Cash: $25,998 (203% of Medicare)

Ins. Median: $16,577 (129% 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
Devoted Health	$14,202	111%
American Progressive	$15,906	124%
Cigna	$15,906 - $21,756	124%
Geisinger	$15,906 - $29,352	124%
Senior Life	$15,906	124%
UnitedHealthcare	$15,906 - $24,934	124%
Amerihealth Caritas Health Plan	$16,224	127%
Gateway	$16,383	128%
Aetna	$16,542 - $22,615	129%
Upmc Health Plan	$16,577 - $21,056	129%
Blue Cross Blue Shield	$16,871 - $34,026	132%
Tricare	$25,577	200%
Ambetter / Centene	$32,403	253%

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 $25,998.
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 Conemaugh Memorial 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.