CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Physicians Regional Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $12,758
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Physicians Regional Medical Center is $12,758. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.00x the Medicare baseline. Located in 7565 Dannaher Way Powell, Powell, TN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$12,758

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%)
Insurance Median: $12,758 (100%)
Ins. Median: $12,758 (100% 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.

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 $1,459 11%
UnitedHealthcare $1,459 - $13,938 11%
Novanet Work Comp Tn $2,324 18%
Occunet Work Comp Tn $2,347 18%
Tn Work Comp $2,347 18%
Self Pay $3,826 - $3,983 30%
Blue Cross Blue Shield $6,960 - $24,184 54%
Multiplan $9,496 - $12,485 74%
Node Bluecare Plus Tn Mcr Adv $11,230 - $11,424 88%
Humana $12,358 - $12,388 96%
Medicare (plans) $12,388 - $13,045 97%
Node Farm Bureau Mcr Adv $12,605 98%
Aetna $12,758 - $16,860 100%
Node Healthspring Mcr Adv $12,758 100%
Amerigroup $13,005 102%
Wellcare $13,078 102%
Node Va $13,276 - $13,542 104%
Node Devoted Health Mcr Adv $13,306 104%
Node Nhc Mcr Adv $13,623 106%
Node Us Dept Of Labor $19,378 151%
Us Department Of Labor $19,378 151%
Cigna $20,765 162%
Node Point Comfort Underwriters $23,319 - $24,561 182%
Ambetter / Centene $24,561 192%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7565 Dannaher Way Powell, Powell, TN 37849
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals