CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: USC Verdugo Hills Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $21,699
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.54x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at USC Verdugo Hills Hospital is $21,699. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.54x the Medicare baseline. Located in 1812 Verdugo Blvd, Glendale, CA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$21,699

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%)

Insurance Median: $21,699 (154%)

Ins. Median: $21,699 (154% 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
Healthnet	$18,902 - $19,197	134%
Aetna	$19,197 - $22,852	136%
Blue Cross Blue Shield	$19,197 - $70,297	136%
Blue Shield	$19,197 - $23,631	136%
Facey Medical Group	$19,197 - $23,036	136%
Kaiser Permanente	$19,197	136%
Pacific Pace	$19,197	136%
UnitedHealthcare	$19,197 - $31,496	136%
Providence Health Plan	$22,460 - $25,779	159%
Imperial Health	$23,893	169%
Cigna	$32,335	229%
Monarch Health Plan	$36,364 - $39,394	258%
Kaweah Delta Health Care	$43,171	306%
Health Plan Of Nevada/Sierra	$56,066	397%

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 $X.
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 USC Verdugo Hills Hospital 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.