CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Saint Francis Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $19,423
Cash Discount Price: $19,422
vs. Medicare Baseline: 1.38x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Saint Francis Medical Center is $19,423. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19,422. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.38x the Medicare baseline. Located in 3630 East Imperial Highway, Lynwood, CA.

Cash / Self-Pay

$19,422

Average discount available for prompt cash payment at this facility.

Insurance Median

$19,423

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: $19,422 (138%)

Insurance Median: $19,423 (138%)

Cash: $19,422 (138% of Medicare)

Ins. Median: $19,423 (138% 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
Alignment	$19,423	138%
Altamed	$19,423	138%
Avanti Hospitals, Llc	$19,423	138%
Blue Shield Of Ca, Va	$19,423	138%
Blue Shield Of Promise	$19,423	138%
Elite Health Plan	$19,423	138%
Health Net Of Ca	$19,423 - $31,562	138%
Kaiser Hospital Foundation	$19,423	138%
La Care Health Plan	$19,423 - $23,307	138%
Medicare (plans)	$19,423	138%
Molina	$19,423	138%
Renal Payer Solutions	$19,423	138%
UnitedHealthcare	$19,423 - $38,306	138%
Welbe Health Pace	$19,423	138%
Tricare	$19,601	139%
Brand New Day	$19,617 - $22,484	139%
Aids Healthcare Foundation	$19,811	140%
Imperial Health Plan Of Ca	$20,588	146%
Keenan	$22,050	156%
Aetna	$26,221	186%
Multiplan	$34,394	244%
Coventry Healthcare Wc, Inc.	$36,596	259%
Worker Comp	$37,728	267%

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 $19,422.
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 Saint Francis Medical Center 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.