CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Oak Valley Hospital District

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $20,497
Cash Discount Price: $44,112
vs. Medicare Baseline: 1.45x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Oak Valley Hospital District is $20,497. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44,112. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.45x the Medicare baseline. Located in 350 S Oak Ave, Oakdale, CA.

Cash / Self-Pay

$44,112

Average discount available for prompt cash payment at this facility.

Insurance Median

$20,497

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: $44,112 (312%)

Insurance Median: $20,497 (145%)

Cash: $44,112 (312% of Medicare)

Ins. Median: $20,497 (145% 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
Blue Cross Blue Shield	$3,440 - $52,934	24%
Healthnet Medi-Cal Ip/Op Only	$5,636	40%
UnitedHealthcare	$9,820	70%
Hp Of San Joaquin Ip/Op Only-All Plans	$13,819	98%
Aetna	$15,120	107%
Kaiser Mcr Adv Ip/Op Only	$18,213	129%
Scan Health Plan Ip/Op Only-All Plans	$18,577	132%
Blue Shield Epn Ip/Op Only	$18,900	134%
Imperial Health Ip/Op Only-All Plans	$20,034	142%
Blue Shield/Bcout Ip/Op Only-All Other Plans	$20,960	148%
Kaiser Medi-Cal Ip/Op Only	$26,132	185%
Medi-Cal Ip/Op Only	$26,132	185%
Kaiser Comm Ip/Op Only-All Other Plans	$36,466	258%
Cigna	$39,406	279%

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 $44,112.
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 Oak Valley Hospital District 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.