CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Carilion New River Valley Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $92,547
Cash Discount Price: $52,244
vs. Medicare Baseline: 7.23x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Carilion New River Valley Medical Center is $92,547. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $52,244. Compared to the federal Medicare reimbursement reference rate of $12,807.1, this hospital’s rate is 7.23x the Medicare baseline. Located in 2900 Lamb Circle, Christiansburg, VA.

Cash / Self-Pay

$52,244

Average discount available for prompt cash payment at this facility.

Insurance Median

$92,547

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: $52,244 (408%)

Insurance Median: $92,547 (723%)

Cash: $52,244 (408% of Medicare)

Ins. Median: $92,547 (723% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 723% of the Medicare baseline (a markup of 623%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$15,475 - $99,115	121%
Humana	$16,133 - $17,371	126%
Blue Cross Blue Shield	$16,792 - $60,697	131%
UnitedHealthcare	$16,956 - $122,013	132%
Sentara Health Plan	$17,286 - $92,547	135%
Vhn - Ultra	$92,547	723%
Cigna	$100,607 - $107,474	786%
Gateway - Tier 3	$101,503	793%
Connecticare	$104,488	816%
Vhn - Plus	$114,937	897%
Gateway - Tier 2	$119,415	932%
Vhn	$119,415	932%
Vhn - Link	$134,342	1049%
Gateway - Tier 1	$141,806	1107%
Vhn - Secondary Payors	$141,806	1107%

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 $52,244.
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 Carilion New River Valley 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.