CMS Price Transparency Data
Sepsis treatment (inpatient stay)
Facility: Adventist Health White Memorial
Billing Code: 871 (MS-DRG)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 871
- Insurance Median: $32,949
- Cash Discount Price: $32,241
- vs. Medicare Baseline: 2.33x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Adventist Health White Memorial is $32,949. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32,241. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 2.33x the Medicare baseline. Located in 1720 Cesar E Chavez Avenue, Los Angeles, CA.
Cash / Self-Pay
$32,241
Average discount available for prompt cash payment at this facility.
Insurance Median
$32,949
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: $32,241 (228%)
Insurance Median: $32,949 (233%)
Cash: $32,241 (228% of Medicare)
Ins. Median: $32,949 (233% 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 233% of the Medicare baseline (a markup of 133%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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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 |
|---|---|---|
| Sunlight Living Hlth Mcal | $1,883 | 13% |
| UnitedHealthcare | $11,332 - $77,466 | 80% |
| Kindred Ip Only-All Plans | $13,100 | 93% |
| Care First Medi-Cal | $15,000 | 106% |
| Blue Shield Medi-Cal | $15,433 | 109% |
| Preferred Ipa La Care Mcal Cap | $16,450 | 117% |
| Access Group | $19,149 | 136% |
| Ahp - All Other Plans | $19,149 | 136% |
| Lasalle Mg Commercial - All Other Plans | $19,149 | 136% |
| Bright Health - All Plans | $20,882 | 148% |
| Blue Shield Mcr Adv | $22,078 | 156% |
| Access Senior - All Other Plans | $22,528 | 160% |
| Ahp Senior | $22,528 | 160% |
| Altamed Connect | $22,528 | 160% |
| Brand New Day Mcare - All Plans | $22,528 | 160% |
| Bs Va Mcare | $22,528 | 160% |
| Care First Mcare - All Other Plans | $22,528 | 160% |
| Healthnet Mcr Adv | $22,528 | 160% |
| Humana | $22,528 | 160% |
| Lasalle Mg Senior | $22,528 | 160% |
| Medicare (plans) | $22,528 | 160% |
| Molina Mcare | $22,528 | 160% |
| Pacific Alliance Medi-Cal | $22,528 | 160% |
| Preferred Senior | $22,528 | 160% |
| Scan Health Mcare - All Plans | $22,528 | 160% |
| Sunlight Living Hlth Mcr Adv-All Other Plans | $22,528 | 160% |
| Tricare | $22,528 | 160% |
| Clever Care - All Plans | $22,728 | 161% |
| Pacific Alliance Mcare - All Other Plans | $22,979 | 163% |
| La Care Mcr Adv - All Plans | $23,246 | 165% |
| Blue Cross Blue Shield | $23,429 - $98,664 | 166% |
| Avanti Mcr Adv - All Other Plans | $24,394 | 173% |
| Assoc Hispanic Physcns Hmo/Mcr Adv-All Other Plans | $27,034 | 192% |
| Preferred Commercial - All Other Plans | $27,034 | 192% |
| Intergrated Medical - All Plans | $27,528 | 195% |
| Altamed Medi-Cal - All Other Plans | $27,743 | 197% |
| Alta Los Angeles Mcr 1/1/19-All Other Plans | $29,461 | 209% |
| Molina Benefit Exchange - All Other Plans | $30,413 | 215% |
| Php-Prospect Health Plan Cap - All Plans | $32,666 | 231% |
| Caremore Mcare - All Plans | $32,744 | 232% |
| Access Medi-Cal | $33,154 | 235% |
| Ahp Medi-Cal | $33,154 | 235% |
| Lasalle Mg Medi-Cal | $33,154 | 235% |
| Medi-Cal | $33,154 | 235% |
| Molina Medi-Cal | $33,154 | 235% |
| Pacific Ipa Medi-Cal | $33,154 | 235% |
| Preferred Medi-Cal | $33,154 | 235% |
| Avanti Mcal | $34,938 | 247% |
| Healthcare Inc Medi-Cal | $35,310 | 250% |
| Alta Los Angeles Mcal 1/1/19 | $36,337 | 257% |
| Healthcare Inc - All Other Plans | $39,114 | 277% |
| Healthnet Mcal | $39,487 | 280% |
| Bc Medi-Cal | $39,677 | 281% |
| Ah Employee Health Plan - All Plans | $40,551 | 287% |
| Preferred Healthy | $41,443 | 294% |
| Assoc Hispanic Physcns Mcal | $46,416 | 329% |
| Centivo - All Plans | $50,689 | 359% |
| Blue Shield Epn | $52,644 | 373% |
| Hcpamg - All Plans | $54,906 | 389% |
| Blue Shield - All Other Plans | $60,120 | 426% |
| Healthnet Comm Care | $62,994 | 446% |
| Pacific Ipa - All Other Plans | $64,553 | 457% |
| Healthnet - All Other Plans | $69,744 | 494% |
| Kaiser- All Plans | $73,437 | 520% |
| Cigna | $80,399 - $87,880 | 570% |
| Aetna | $89,349 | 633% |
| Interplan Ppo - All Plans | $92,980 | 659% |
| First Heatlh Ppo - All Plans | $103,887 | 736% |
| Western Growers/Pinnacle - All Plans | $107,040 | 758% |
| Phcs Ppo - All Plans | $116,425 | 825% |
| Beech Street - All Plans | $120,007 | 850% |
| Ahf - All Plans | $134,337 | 952% |
| Corvel Corp - All Plans | $143,292 | 1015% |
| Multiplan Ppo - All Plans | $148,666 | 1053% |
| Healthmannet - All Plans | $152,248 | 1078% |
| Next Inc Ppo - All Plans | $152,248 | 1078% |
| Trpn - All Plans | $152,248 | 1078% |
| Fpn Ppo - All Plans | $161,204 | 1142% |