CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Princeton Community Hospital Assn Inc

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $17,499
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.37x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Princeton Community Hospital Assn Inc is $17,499. 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 1.37x the Medicare baseline. Located in 122 12Th Street, Princeton, WV.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$17,499

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: $17,499 (137%)

Ins. Median: $17,499 (137% 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
Blue Cross Blue Shield	$13,212 - $42,576	103%
Medicare (plans)	$13,212 - $14,005	103%
Aetna	$13,873 - $20,461	108%
Humana	$13,873	108%
UnitedHealthcare	$14,401	112%
Pennsylvania Health & Wellness	$19,122	149%
Highmark Health Options West Va	$20,079	157%
Wellpoint West Virginia	$20,079	157%
The Health Plan Wv	$20,365	159%
Medicaid / KanCare	$41,579	325%
Optima Health Plan	$41,579	325%

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 Princeton Community Hospital Assn Inc 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.