CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Memorial Hermann Sugar Land Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $15,922
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.24x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Memorial Hermann Sugar Land Hospital is $15,922. 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 1.24x the Medicare baseline. Located in 17500 W Grand Parkway South, Sugar Land, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$15,922

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: $15,922 (124%)

Ins. Median: $15,922 (124% 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
Kelseycare	$15,444	121%
Aetna	$15,922 - $26,271	124%
Amerivantage	$15,922	124%
Blue Cross Blue Shield	$15,922	124%
Cigna	$15,922	124%
Devoted Health	$15,922	124%
Humana	$15,922	124%
Kaiser Permanente	$15,922	124%
Medicare (plans)	$15,922	124%
Memorial Hermann	$15,922	124%
Tdc Prisoner	$15,922	124%
UnitedHealthcare	$15,922 - $25,475	124%
Wellcare	$15,922	124%
Wellpoint	$15,922 - $25,475	124%
Community Health	$17,514 - $25,475	137%
Molina Healthcare	$17,514 - $30,729	137%
Procare Advantage	$18,310	143%
United Kelseyseybold	$24,679	193%
Oscar	$25,475	199%
Superior Healthplan	$25,475	199%
90 Degrees	$30,252	236%

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 Memorial Hermann Sugar Land Hospital 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.