CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Christus Spohn Hospital Alice

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $12,435
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.97x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Christus Spohn Hospital Alice is $12,435. 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 0.97x the Medicare baseline. Located in 2500 E Main Street, Alice, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$12,435

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: $12,435 (97%)

Ins. Median: $12,435 (97% 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
Aetna	$2,828 - $23,025	22%
Healthcare Highways	$3,503	27%
Five Point Credit Union	$4,190 - $10,056	33%
Multiplan	$9,371	73%
Phcs	$9,371	73%
Christus Health	$11,469 - $16,902	90%
Allwell	$12,073	94%
Blue Cross Blue Shield	$12,073 - $25,919	94%
Coventry	$12,073	94%
Humana	$12,073 - $27,020	94%
Molina	$12,073	94%
Superior	$12,073	94%
Texas Healthspring	$12,073	94%
Triwest	$12,073	94%
UnitedHealthcare	$12,073 - $22,897	94%
Wellcare	$12,073	94%
Provider Partners Health Plan	$12,435	97%
Texas Independence Health Plan	$12,435	97%
Shared Health Insurance Company	$12,676	99%
Us Imaging Network	$12,918	101%
Amerigroup	$13,038	102%
Devoted Health Plan	$13,038	102%
Imperial Health Plan	$13,280	104%
Medicare (plans)	$13,280	104%
Procare Advantage	$13,280	104%
Cigna	$15,834 - $19,362	124%
Naphcare Inc.	$27,767	217%
Healthsmart	$33,143	259%

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 $X.
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 Christus Spohn Hospital Alice 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.