CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Medical Center Enterprise

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $5,615
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.40x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Medical Center Enterprise is $5,615. 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 $14,116.91, this hospital’s rate is 0.40x the Medicare baseline. Located in 400 N Edwards Street, Enterprise, AL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,615

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$14,116.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $14,116.91 (100%)
Insurance Median: $5,615 (40%)
Ins. Median: $5,615 (40% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $14,116.91 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.

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
Medicaid / KanCare $1,931 14%
Coventry Work Comp Al $2,392 17%
Occunet $2,500 18%
Alamed $2,600 18%
Wc Dept Ind Relations $2,600 18%
Blue Cross Blue Shield $3,026 - $12,661 21%
UnitedHealthcare $3,721 - $13,283 26%
Humana $13,052 92%
Medicare (plans) $13,052 92%
Select Health $13,182 93%
Healthspring $13,312 94%
Node Devoted Health Mcr Adv $13,312 94%
Node Clover Mcr Adv $13,416 95%
Aetna $13,442 95%
Node Va $13,549 96%
Node Wellcare Mcr Adv $13,549 96%
Eon Health $13,703 97%
Cigna $14,843 105%
Ambetter / Centene $17,844 126%
Node Us Dept Of Labor $19,386 137%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 N Edwards Street, Enterprise, AL 36330
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals