CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Geisinger Wyoming Valley Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $30,833
Cash Discount Price: $92,414
vs. Medicare Baseline: 2.41x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Geisinger Wyoming Valley Medical Center is $30,833. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $92,414. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 2.41x the Medicare baseline. Located in 1000 East Mountain Boulevard, Wilkes Barre, PA.

Cash / Self-Pay

$92,414

Average discount available for prompt cash payment at this facility.

Insurance Median

$30,833

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: $92,414 (722%)

Insurance Median: $30,833 (241%)

Cash: $92,414 (722% of Medicare)

Ins. Median: $30,833 (241% 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 241% of the Medicare baseline (a markup of 141%). 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
Humana	$11,088	87%
Life Geisinger	$11,088	87%
Medicare (plans)	$11,088 - $12,529	87%
Blue Cross Blue Shield	$11,199 - $40,085	87%
Geisinger Health Plan	$11,498 - $32,795	90%
Ambetter / Centene	$26,057	203%
Aetna	$43,725 - $99,569	341%
UnitedHealthcare	$52,414	409%
Cigna	$67,522	527%
Christian Healthcare Ministries	$74,528	582%
Wyoming Seminary	$104,339	815%
Intergroup Services	$126,697	989%
Multiplan	$126,697	989%

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 $92,414.
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 Geisinger Wyoming Valley 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.