CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Banner Boswell Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $15,823
Cash Discount Price: $20,688
vs. Medicare Baseline: 1.12x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Banner Boswell Medical Center is $15,823. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20,688. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.12x the Medicare baseline. Located in 13632 N 99Th Ave, Sun City, AZ.

Cash / Self-Pay

$20,688

Average discount available for prompt cash payment at this facility.

Insurance Median

$15,823

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: $20,688 (147%)

Insurance Median: $15,823 (112%)

Cash: $20,688 (147% of Medicare)

Ins. Median: $15,823 (112% 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	$15,069 - $49,722	107%
Arizona Physicians Ipa	$15,069	107%
Banner Health	$15,069	107%
Banner University Health Plan	$15,069	107%
Blue Cross Blue Shield	$15,069 - $43,699	107%
Care 1St	$15,069	107%
Cigna	$15,069 - $59,383	107%
Gila River Health Care Corporation	$15,069	107%
Health Choice Arizona, Inc.	$15,069 - $22,604	107%
Health Net	$15,069 - $22,302	107%
Humana	$15,069 - $15,521	107%
Kaiser Foundation Health Plan	$15,069	107%
Mercy Care	$15,069	107%
Triwest Healthcare Alliance Corp - Va Ccn	$15,069	107%
UnitedHealthcare	$15,069 - $52,031	107%
Upmc Health Plan	$15,069	107%
Wellpoint	$15,069	107%
Carelon	$15,823	112%
Devoted Health Services	$15,823	112%
Arizona Priority Care	$16,576	117%
Gold Kidney Health Plan	$16,576	117%
Oscar Health Plan	$24,864	176%

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 $20,688.
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 Boswell 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.