CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Southern Hills Hospital and Medical Center

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 322
Insurance Median: $19,383
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.51x Medicare

The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Southern Hills Hospital and Medical Center is $19,383. 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 1.51x the Medicare baseline. Located in 9300 West Sunset Rd, Las Vegas, NV.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$19,383

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: $19,383 (151%)

Ins. Median: $19,383 (151% 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
Molina Healthcare	$1,550	12%
Humana	$2,368 - $19,983	18%
Sierra	$2,732 - $22,136	21%
Multiplan	$3,186	25%
First Health	$3,456	27%
Select Health	$3,566 - $29,896	28%
United	$3,574 - $29,720	28%
Hometown Health Providers	$3,784 - $4,612	30%
Health Services Coalition	$3,896 - $4,110	30%
Prominence Healthfirst	$4,095	32%
Aetna	$4,123 - $23,372	32%
Cigna	$4,347 - $49,500	34%
Procare Hospice	$16,781 - $16,985	131%
Unified Care Hospice	$16,781 - $16,985	131%
Hometown Health McR	$19,151 - $19,383	150%
Blue Cross Blue Shield	$19,743 - $33,890	154%
Triwest	$19,743 - $19,983	154%
Alignment Health Plan	$19,743 - $19,983	154%
Ambetter / Centene	$19,743 - $35,969	154%
Caremore	$20,138 - $20,382	157%
Imperial Nv	$20,730 - $20,982	162%
Universal Healthcare	$21,125 - $21,381	165%

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 Southern Hills Hospital and 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.