CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Sonoma Valley Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $19,275
  • Cash Discount Price: $54,047
  • vs. Medicare Baseline: 1.37x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Sonoma Valley Hospital is $19,275. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $54,047. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.37x the Medicare baseline. Located in 347 Andrieux St, Sonoma, CA.
Cash / Self-Pay
$54,047

Average discount available for prompt cash payment at this facility.

Insurance Median
$19,275

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: $54,047 (383%)
Insurance Median: $19,275 (137%)
Cash: $54,047 (383% of Medicare)
Ins. Median: $19,275 (137% 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
Hospice Of Marin-All Plans $2,276 16%
By The Bay Health Ip Only - All Plans $2,550 18%
Ppo Alliance-All Plans $2,745 19%
Comm Care Network(Ccn)-All Plans $3,000 21%
Great West-One Health Plan Ppo/Pos-All Plans $3,075 22%
Bps-All Plans $3,545 25%
Pref Health Networl(Phn)-All Plans $4,289 30%
Interplan-All Plans $5,035 36%
Blue Cross Blue Shield $7,495 - $19,275 53%
Pacificare (Mipa)-All Plans $7,662 54%
Healthnet Hmo/Ppo-All Other Plans $9,639 68%
Mcal Mgd Care (Php)-All Plans $10,178 72%
Partnership Healthplan-All Plans $10,178 72%
St Joseph Heritage Hltcare Comm-All Other Plans $12,315 87%
Phcs/Multiplan/Beech St-All Plans $15,000 106%
Medi-Cal $15,959 113%
Blue Shield Ppo-All Plans $16,096 114%
Champus-All Plans $16,384 116%
Tricare $18,697 132%
Bright Hlth/Brand New Day Mcr Adv $19,275 137%
Healthnet Senior $19,275 137%
Marin General Comm/Mcr Adv (Western Hlth)-All Plans $19,275 137%
St Joseph Heritage Hltcare Mcr Adv $19,275 137%
UnitedHealthcare $19,275 - $29,859 137%
Veterans Admin-All Plans $19,275 137%
Scan Mcare-All Plans $19,398 137%
Aetna $21,934 155%
First Health(Coventry)-All Plans $21,934 155%
Cigna $22,062 156%
Cdcr Prison-All Plans $23,130 164%
Correct Care Integ Health-All Plans $23,130 164%
Employer Direct Healthcare-All Plans $23,130 164%
Three Rivers (Trpn)-All Plans $23,130 164%
Chp - Correctional Health Partners - All Plans $25,058 178%
Creative Legal Services-All Plans $25,058 178%
Wellpath - All Plans $26,985 191%
Bright Hlth/Brand New Day - All Other Plands $27,949 198%
Canopy Health Solutions-All Other Plans $29,588 210%
M-Cal (Eds) Ip Only - All Plans $31,965 226%
Vnpn - All Plans $34,696 246%
Kaiser-All Plans $50,187 356%
Integrated Health Plan-All Plans $57,136 405%
Networks By Design - All Plans $61,768 438%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 347 Andrieux St, Sonoma, CA 95476
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals