CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Banner Gateway Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $19,540
  • Cash Discount Price: $29,238
  • vs. Medicare Baseline: 1.38x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Banner Gateway Medical Center is $19,540. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $29,238. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.38x the Medicare baseline. Located in 1900 North Higley Road, Gilbert, AZ.
Cash / Self-Pay
$29,238

Average discount available for prompt cash payment at this facility.

Insurance Median
$19,540

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: $29,238 (207%)
Insurance Median: $19,540 (138%)
Cash: $29,238 (207% of Medicare)
Ins. Median: $19,540 (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.

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 $18,177 - $52,208 129%
Arizona Physicians Ipa $18,177 129%
Banner Health $18,177 129%
Banner University Health Plan $18,177 129%
Blue Cross Blue Shield $18,177 - $43,807 129%
Care 1St $18,177 129%
Cigna $18,177 - $59,383 129%
Gila River Health Care Corporation $18,177 129%
Health Choice Arizona, Inc. $18,177 - $27,266 129%
Health Net $18,177 - $26,902 129%
Humana $18,177 - $18,722 129%
Kaiser Foundation Health Plan $18,177 129%
Mercy Care $18,177 129%
Triwest Healthcare Alliance Corp - Va Ccn $18,177 129%
UnitedHealthcare $18,177 - $52,031 129%
Upmc Health Plan $18,177 129%
Wellpoint (Fka Amerigroup) $18,177 129%
Carekin $19,086 135%
Devoted Health Services $19,086 135%
Arizona Priority Care $19,995 142%
Gold Kidney Health Plan $19,995 142%
Oscar Health Plan $29,992 212%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1900 North Higley Road, Gilbert, AZ 85234
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals