CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Methodist Celina Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $18,026
Cash Discount Price: $43,300
vs. Medicare Baseline: 1.41x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Methodist Celina Medical Center is $18,026. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43,300. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 1.41x the Medicare baseline. Located in 1500 S Dallas Parkway, Celina, TX.

Cash / Self-Pay

$43,300

Average discount available for prompt cash payment at this facility.

Insurance Median

$18,026

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: $43,300 (338%)

Insurance Median: $18,026 (141%)

Cash: $43,300 (338% of Medicare)

Ins. Median: $18,026 (141% 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	$12,605 - $20,421	98%
Blue Cross Blue Shield	$12,605 - $24,729	98%
Mcs Advantage, Inc Classicare [7021]	$12,605	98%
Medicare (plans)	$12,605 - $13,488	98%
UnitedHealthcare	$12,605 - $13,362	98%
Ust Health Proof [1005]	$12,605	98%
Wellcare [7016]	$12,605	98%
American Health Advantage Of Texas [7099]	$13,236	103%
Cigna	$13,236 - $20,806	103%
Humana	$13,362	104%
Southwestern Health Resources Swhr [7015]	$13,362	104%
Medicaid / KanCare	$13,527	106%
Oscar Insurance Company [2057]	$17,647	138%
Department Of Labor [8004]	$18,026	141%
Generic Workers Comp Tx Non Par [9010]	$18,026	141%
Generic Workers Comp Tx Par [8002]	$18,026	141%
Generic Workers Comp Tx Par [9011]	$18,026	141%
Molina [3017]	$18,278	143%
Sana Benefits [3069]	$18,908	148%
Wellpoint Marketplace Exchange [3071]	$19,538	153%
90 Degree Benefit [3057]	$20,799	162%
Allied National [2031]	$20,799	162%
Entrust/90 Degree [2058]	$20,799	162%
Web Tpa [3049]	$20,806	162%
Kempton Group Administrators, Tower Extrusions [3061]	$21,156	165%
Champva [1000]	$22,414	175%
Tricare	$22,414	175%
Triwest Wps [8010]	$22,414	175%
Veterans Administration [9001]	$22,414	175%
Imperial Insurance Companies [3073]	$22,689	177%
Evry Health [1013]	$31,513	246%
Medical Cost Containment Professionals [3059]	$31,513	246%
Velocity [3070]	$31,513	246%

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 $43,300.
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 Methodist Celina Medical Center 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.