CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Riverside Community Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $24,217
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.72x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Riverside Community Hospital is $24,217. 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 1.72x the Medicare baseline. Located in 4445 Magnolia Avenue, Riverside, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$24,217

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: $24,217 (172%)
Ins. Median: $24,217 (172% 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
Redlands Community $3,350 24%
First Health $3,407 24%
Health Net $4,784 34%
Cigna $5,314 - $12,255 38%
Blue Shield $5,666 - $9,137 40%
United $6,116 - $24,241 43%
Aetna $6,944 - $24,217 49%
Blue Cross Blue Shield $7,182 - $34,020 51%
Vitas Healthcare Hospice $16,952 120%
Bright Health $17,949 - $30,110 127%
Bristol Hospice $19,374 137%
Brand New Day $23,733 - $36,325 168%
Alignment Health Plan $24,217 172%
Central Health Plan $24,217 172%
Clever Care Of Golden State $24,217 - $25,428 172%
Easy Choice Health Plan $24,217 172%
Heritage Provider Network $24,217 - $34,146 172%
Humana $24,217 172%
Medcare Partners $24,217 - $25,428 172%
Redlands Community Hospital $24,217 172%
Riverside Physician $24,217 172%
Scan Health Plan $24,217 172%
Triwest Healthcare Alliance $24,217 172%
UnitedHealthcare $24,217 172%
Care1St Health Plan $24,701 175%
Corvel Corporation $37,228 264%
Healthsmart $37,604 266%
Next $37,604 266%
Inland Empire Health Plan $43,590 309%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4445 Magnolia Avenue, Riverside, CA 92501
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals