CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Houston Methodist the Woodlands Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $13,882
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.08x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Houston Methodist the Woodlands Hospital is $13,882. 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 1.08x the Medicare baseline. Located in 17201 Interstate 45 South, The Woodlands, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$13,882

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: $13,882 (108%)

Ins. Median: $13,882 (108% 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	$9,936 - $12,986	78%
Blue Cross Blue Shield	$12,795 - $27,743	100%
Humana	$12,795 - $41,144	100%
Texas Monarch	$12,795	100%
Triwest Healthcare	$12,795	100%
UnitedHealthcare	$12,795 - $40,706	100%
Cigna	$13,178 - $23,986	103%
Wellpoint	$13,178	103%
Molina Healthcare	$13,434 - $25,589	105%
Oscar	$13,434	105%
Community Health Choice	$13,690 - $24,310	107%
Devoted Health	$13,690 - $15,993	107%
Texas Annual Conference	$20,855 - $24,310	163%
Advanced Medical Pricing Solutions	$25,589	200%
Entrust	$27,399	214%

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 Houston Methodist the Woodlands 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.