CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Saint Agnes Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $19,377
  • Cash Discount Price: $44,730
  • vs. Medicare Baseline: 1.37x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Saint Agnes Medical Center is $19,377. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44,730. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.37x the Medicare baseline. Located in 1303 E Herndon Ave, Fresno, CA.
Cash / Self-Pay
$44,730

Average discount available for prompt cash payment at this facility.

Insurance Median
$19,377

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: $44,730 (317%)
Insurance Median: $19,377 (137%)
Cash: $44,730 (317% of Medicare)
Ins. Median: $19,377 (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
Health Smart $3,275 23%
Interplan $3,275 23%
Cba Network By Design $5,700 40%
Network Health $5,700 40%
Healthnet $5,873 - $6,538 42%
Coventry $7,425 53%
Aetna $7,613 - $19,377 54%
Multiplan $8,205 58%
Phcs $8,205 58%
Meritain $8,483 60%
Trustmark Small Business Benefits $8,483 60%
Allied Benefit Systems $8,956 63%
Boon Chapman $8,956 63%
Hap $8,956 63%
Webtpa $8,956 63%
Advantek Central Usd $10,587 75%
Blue Cross Blue Shield $10,958 - $45,588 78%
Allegiance $13,395 95%
American Postal Workers Secondary $13,395 95%
Cigna $13,395 95%
Medicare (plans) $17,357 - $20,365 123%
Humana $19,377 - $19,772 137%
UnitedHealthcare $19,764 - $35,991 140%
Welbe Health $22,648 160%
Align Senior Care $22,738 161%
Kaiser Permanente $34,601 245%
Geha $35,991 255%
Blue Shield - Ca $36,795 - $45,588 261%
Blue Benefit Administrators Of Massachusetts $45,588 323%
Blue Care Network $45,588 323%
Blue Distinction Transplant $45,588 323%
Blue Shield - Id (Regence) $45,588 323%
Blue Shield - Ny Highmark Northeastern $45,588 323%
Blue Shield - Ny Highmark Western $45,588 323%
Blue Shield - Pa (Highmark) $45,588 323%
Blue Shield - Wa (Regence) $45,588 323%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1303 E Herndon Ave, Fresno, CA 93720
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals