CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Prisma Health Baptist

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $15,776
Cash Discount Price: $34,329
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Prisma Health Baptist is $15,776. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $34,329. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.23x the Medicare baseline. Located in 1330 Taylor at Marion St, Columbia, SC.

Cash / Self-Pay

$34,329

Average discount available for prompt cash payment at this facility.

Insurance Median

$15,776

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: $34,329 (268%)

Insurance Median: $15,776 (123%)

Cash: $34,329 (268% of Medicare)

Ins. Median: $15,776 (123% 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
Medicaid / KanCare	$5,073	40%
UnitedHealthcare	$5,073 - $56,085	40%
Blue Cross Blue Shield	$15,025 - $74,473	117%
Cigna	$15,025 - $42,529	117%
Humana	$15,025	117%
Medicare (plans)	$15,025 - $15,776	117%
Ambetter / Centene	$15,060	118%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904]	$15,060	118%
Triwest Healthcare Alliance Vcp [902]	$15,060	118%
Va Community Care Network-Vaccn [903]	$15,060	118%
Aetna	$15,776	123%
Healthy Conn Prime-First Choice Vip Care [5300]	$15,776	123%
Healthy Conn Prime-Molina Healthcare [5330]	$15,776	123%
Healthy Conn Prime-Wellcare Prime By Atc [5310]	$15,776	123%
Workers Comp [600]	$21,035	164%
Preferred Administrators Contracted [2839]	$31,307	244%
Bluechoice [810]	$33,962 - $74,646	265%
Promise Health Plan Contracted [2401]	$34,378	268%
Scdc-Sc Dept Of Corrections [7232]	$38,409	300%
Evernorth Behavioral Contracted [2982]	$42,529	332%
Golden Rule Insurance Company [2991]	$56,085	438%
Oxford Health Plans [2992]	$56,085	438%
Zzumr-Salt Lake City Ut [3169]	$56,085	438%
Planned Administrators [820]	$74,473	581%

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 $34,329.
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 Prisma Health Baptist 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.