CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Grandview Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $5,156
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.37x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Grandview Medical Center is $5,156. 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 0.37x the Medicare baseline. Located in 3690 Grandview Parkway, Birmingham, AL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,156

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: $5,156 (37%)
Ins. Median: $5,156 (37% 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
Healthchoice $1,500 11%
Natl Comp Care $2,802 20%
Coventry Work Comp Al $3,033 21%
First Health $3,033 21%
Novanet $3,132 22%
UnitedHealthcare $3,135 - $13,836 22%
Alabama Wc $3,297 23%
Blue Cross Blue Shield $3,352 24%
Viva Health $3,763 - $12,920 27%
Alamed $4,392 31%
Healthspring $10,004 71%
Blue Advantage $12,252 87%
Humana $12,895 91%
Victory Health $12,895 91%
Medicare (plans) $12,920 - $13,462 92%
Select Health $13,049 92%
Cigna $13,178 - $20,177 93%
Aetna $13,307 94%
Node Wellcare Mcr Adv $13,385 95%
Node Devoted Health Mcr Adv $13,730 97%
Node Clover Health Mcr Adv $13,838 98%
Node Va $13,975 99%
Choicecare $16,511 117%
Ambetter / Centene $18,702 132%
Node Us Dept Of Labor $19,944 141%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3690 Grandview Parkway, Birmingham, AL 35243
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals