CMS Price Transparency Data
Sepsis treatment (inpatient stay)
Facility: San Antonio Regional Hospital
Billing Code: 871 (MS-DRG)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 871
- Insurance Median: $23,088
- Cash Discount Price: $168,312
- vs. Medicare Baseline: 1.64x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at San Antonio Regional Hospital is $23,088. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $168,312. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.64x the Medicare baseline. Located in 999 San Bernardino Road, Upland, CA.
Cash / Self-Pay
$168,312
Average discount available for prompt cash payment at this facility.
Insurance Median
$23,088
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: $168,312 (1192%)
Insurance Median: $23,088 (164%)
Cash: $168,312 (1192% of Medicare)
Ins. Median: $23,088 (164% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| San Bernardino Cnty Ip Only-All Plans | $9,000 | 64% |
| Foundation Inland Epo-All Other Plans | $13,286 | 94% |
| Foundation Inland Ppo | $18,016 | 128% |
| Tricare | $18,880 | 134% |
| Aetna | $19,265 - $56,533 | 136% |
| Alpha Care Mg Mcr Adv | $19,265 | 136% |
| Blue Shield Mcr Adv | $19,265 | 136% |
| Caremore Mcr Adv - All Plans | $19,265 | 136% |
| Central Hlth Plan Mcr Adv-All Plans | $19,265 | 136% |
| Choice Phycn Ntwrk Mcr Adv-All Other Plans | $19,265 | 136% |
| Epic Health Plan Mcr Adv | $19,265 | 136% |
| Healthnet Mcr Adv | $19,265 | 136% |
| Humana | $19,265 | 136% |
| Iehp Mcr Adv | $19,265 | 136% |
| Imperial Health Mcr Adv-All Plans | $19,265 | 136% |
| Inter Valley Hp Mcr Adv- All Plans | $19,265 | 136% |
| Kindred Mcr Adv-All Plans | $19,265 | 136% |
| Molina Mcr Adv | $19,265 | 136% |
| Prospect Hp-All Plans | $19,265 | 136% |
| Providence Clevercare Mcr Adv | $19,265 | 136% |
| Scan Health Plan Mcr Adv-All Plans | $19,265 | 136% |
| Universal Care - All Plans | $19,265 | 136% |
| Heritage Prov Ntwrk/Regal Mcr Adv | $19,554 | 139% |
| Blue Cross Blue Shield | $19,650 - $78,734 | 139% |
| Wellcare/Easy Choice-All Plans | $19,650 | 139% |
| Clever Care Mcr Adv - All Plans | $20,228 | 143% |
| La Salle Hp Mcr Adv-All Plans | $20,228 | 143% |
| Zelis Mcr Adv | $20,228 | 143% |
| Kasiser Mcr Adv | $20,614 | 146% |
| Medi-Cal | $20,990 | 149% |
| Kaiser Medi-Cal | $22,039 | 156% |
| Healthnet Medi-Cal | $22,144 | 157% |
| Blue Shield Epn | $22,622 | 160% |
| Molina Medi-Cal | $22,879 | 162% |
| Alpha Care Mg Mcal/Hlthy Kids | $23,088 | 164% |
| Heritage Prov Ntwrk/Regal Mcal | $23,088 | 164% |
| Choicecare Ntwrk-All Plans | $23,499 | 166% |
| Alpha Care Mg-All Other Plans | $24,081 | 171% |
| Iehp Mcal | $24,348 | 172% |
| Molina Exchange-All Other Plans | $25,045 | 177% |
| Iehp Comm - All Other Plans | $27,934 | 198% |
| Providence Oscar-All Other Plans | $27,934 | 198% |
| Redlands Employee | $28,898 | 205% |
| Redlands Hmo-All Other Plans | $30,054 | 213% |
| Healthnet - All Other Plans | $30,265 | 214% |
| UnitedHealthcare | $31,773 - $58,807 | 225% |
| Pc Inland Valley Scan | $32,161 | 228% |
| Pc Inland Valley-All Other Plans | $32,161 | 228% |
| Prime Health - All Plans | $33,714 | 239% |
| Ambetter / Centene | $34,080 | 241% |
| Cigna | $44,993 | 319% |
| Epic Health Plan - All Other Plans | $49,504 | 351% |
| Heritage Prov Ntwrk/Regal - All Other Plans | $49,557 | 351% |
| Kaiser Comm - All Other Plans | $53,750 | 381% |
| Coventry Ccn/First Hlth - All Plans | $58,288 | 413% |
| Networks By Design - All Plans | $67,348 | 477% |
| Multiplan/Phcs - All Plans | $109,308 | 774% |
| Zelis Comm-All Other Plans | $123,759 | 877% |
| Blue Shield Hmo Pos / Calpers Ppo | $129,276 | 916% |
| Interplan - All Plans | $132,010 | 935% |
| Blue Shield Epo Ppo - All Other Plans | $132,636 | 940% |
| Health Payors - All Plans | $140,260 | 994% |