CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Spotsylvania Regional Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $14,668
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.15x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Spotsylvania Regional Medical Center is $14,668. 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 1.15x the Medicare baseline. Located in 4600 Spotsylvania Parkway, Fredericksburg, VA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$14,668

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: $14,668 (115%)
Ins. Median: $14,668 (115% 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Blue Cross Blue Shield $2,303 - $39,472 18%
United $3,382 - $31,248 26%
Sentara Health $13,970 109%
United Behavioral Health $13,970 109%
Humana $13,970 109%
Align Senior Care $14,249 111%
Devoted $14,249 111%
Cigna $14,249 - $35,194 111%
Virginia Premier Health $14,249 111%
Aetna $14,269 - $32,365 111%
Clear Spring Health Plan $14,668 115%
Lifeworks $14,668 115%
Optima Health $45,981 359%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4600 Spotsylvania Parkway, Fredericksburg, VA 22408
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals