CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Banner Casa Grande Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $19,512
Cash Discount Price: $23,069
vs. Medicare Baseline: 1.38x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Banner Casa Grande Medical Center is $19,512. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23,069. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.38x the Medicare baseline. Located in 1800 East Florence Boulevard, Casa Grande, AZ.

Cash / Self-Pay

$23,069

Average discount available for prompt cash payment at this facility.

Insurance Median

$19,512

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%)

Cash / Self-Pay: $23,069 (163%)

Insurance Median: $19,512 (138%)

Cash: $23,069 (163% of Medicare)

Ins. Median: $19,512 (138% 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.

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
Aetna	$17,738 - $38,971	126%
Arizona Physicians Ipa	$17,738	126%
Banner Health	$17,738	126%
Banner University Health Plan	$17,738	126%
Blue Cross Blue Shield	$17,738 - $28,642	126%
Care 1St	$17,738	126%
Cigna	$17,738 - $42,664	126%
Gila River Health Care Corporation	$17,738	126%
Health Choice Arizona, Inc.	$17,738 - $26,608	126%
Health Net	$17,738 - $26,253	126%
Humana	$17,738 - $18,803	126%
Kaiser Foundation Health Plan	$17,738	126%
Mercy Care	$17,738	126%
Triwest Healthcare Alliance Corp - Va Ccn	$17,738	126%
UnitedHealthcare	$17,738 - $33,128	126%
Upmc Health Plan	$17,738	126%
Wellpoint	$17,738	126%
Carelon	$18,625	132%
Arizona Priority Care	$19,512	138%
Devoted Health Services	$19,512	138%
Gold Kidney Health Plan	$19,512	138%
Oscar Health Plan	$26,608	188%
Naphcare	$28,381	201%

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 $23,069.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 871.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Banner Casa Grande Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 871.
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.