CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Adventist Health Reedley

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $22,074
Cash Discount Price: $8,310
vs. Medicare Baseline: 1.56x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Adventist Health Reedley is $22,074. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,310. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.56x the Medicare baseline. Located in 372 W Cypress Ave, Reedley, CA.

Cash / Self-Pay

$8,310

Average discount available for prompt cash payment at this facility.

Insurance Median

$22,074

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: $8,310 (59%)

Insurance Median: $22,074 (156%)

Cash: $8,310 (59% of Medicare)

Ins. Median: $22,074 (156% 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 Medi-Cal	$6,558	46%
Blue Shield Epn - All Other Plans	$13,695	97%
Blue Shield Non Epn	$15,798	112%
Healthnet- All Other Plans	$16,795	119%
UnitedHealthcare	$19,026 - $25,925	135%
Western Growers/Pinnacle- All Plans	$19,494	138%
Blue Shield Mcare	$21,353	151%
Fhcn Pace Mcr Adv-All Plans	$21,353	151%
Healthnet- Mcr Adv	$21,353	151%
Kaiser Mcr Adv	$21,353	151%
Phs Prime Health Srvcs	$21,353	151%
Tricare	$21,353	151%
Kaiser - All Other Plans	$21,869	155%
Blue Cross Blue Shield	$22,074 - $29,652	156%
Aetna	$25,594 - $35,233	181%
Bright Health Mcr Adv - All Plans	$26,880	190%
Cigna	$28,429	201%
Cal Viva Hlth Mcal - All Plans	$30,393	215%
Kern Health Systems Mcal-All Plans	$30,393	215%
Medi-Cal	$30,393	215%
Bc Mcal	$36,754	260%
Ah Employee Health Plan - All Plans	$38,436	272%
Community Care Ipa Mcal-All Plans	$39,511	280%

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 $8,310.
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 Adventist Health Reedley 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.