Sepsis treatment (inpatient stay)
Facility: Adventist Health Hanford
Billing Code: 871 (MS-DRG)
- CPT Billing Code: 871
- Insurance Median: $28,739
- Cash Discount Price: $14,472
- vs. Medicare Baseline: 2.04x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 204% of the Medicare baseline (a markup of 104%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Interplan- All Plans | $9,068 | 64% |
| Choicecare- All Plans | $16,565 | 117% |
| UnitedHealthcare | $19,132 - $25,588 | 136% |
| Blue Shield Mcr Adv | $20,320 | 144% |
| Fhcn Pace Mcr Adv-All Plans | $20,320 | 144% |
| Healthnet Mcr Adv | $20,320 | 144% |
| Kaiser Mcr Adv | $20,320 | 144% |
| Prime Health Mcr Adv- All Plans | $20,320 | 144% |
| Tricare | $20,320 | 144% |
| Community Hlth Ntwork-All Plans | $21,911 | 155% |
| Kaiser Mcal | $24,839 | 176% |
| Medi-Cal | $24,839 | 176% |
| Phcs Ppo- All Plans | $26,400 | 187% |
| Bright Health Mcr Adv-All Plans | $26,880 | 190% |
| Healthnet Mcal | $28,091 | 199% |
| Bc Mcal | $28,739 | 204% |
| Blue Shield Epn | $32,680 | 231% |
| Aetna | $33,527 - $69,062 | 237% |
| Ah Employee Health Plan - All Plans | $36,575 | 259% |
| Blue Shield Non-Epn - All Other Plans | $37,136 | 263% |
| Kaiser - All Other Plans | $38,085 | 270% |
| Valley Childrens - All Plans | $39,243 | 278% |
| First Health - All Plans | $39,608 | 281% |
| Fresno - All Plans | $41,185 | 292% |
| Cigna | $45,245 | 321% |
| Western Growers/Pinnacle- All Plans | $50,379 | 357% |
| Beech Street- All Plans | $53,319 | 378% |
| Blue Cross Blue Shield | $54,896 - $73,968 | 389% |
| Multiplan- All Plans | $63,221 | 448% |
| Healthnet - All Other Plans | $65,664 | 465% |
| Preferred Health Network- All Plans | $72,361 | 513% |
| Pacific Health Alliance- All Plans | $73,885 | 523% |