CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Sharp Coronado Hospital and Hlthcr Ctr

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $79,582
Cash Discount Price: $105,640
vs. Medicare Baseline: 5.64x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Sharp Coronado Hospital and Hlthcr Ctr is $79,582. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $105,640. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 5.64x the Medicare baseline. Located in 250 Prospect Place, Coronado, CA.

Cash / Self-Pay

$105,640

Average discount available for prompt cash payment at this facility.

Insurance Median

$79,582

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: $105,640 (748%)

Insurance Median: $79,582 (564%)

Cash: $105,640 (748% of Medicare)

Ins. Median: $79,582 (564% 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 564% of the Medicare baseline (a markup of 464%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Health Net	$21,128 - $79,582	150%
Blue Shield	$24,649 - $67,483	175%
Blue Cross Blue Shield	$55,313 - $112,683	392%
Aetna	$59,158	419%
Allianz Global Assistance	$67,483	478%
UnitedHealthcare	$79,582 - $89,864	564%
Interplan	$84,512	599%
Kaiser	$89,442	634%
Humana	$98,597	698%
Managed Health Network	$98,597	698%
Molina	$98,597	698%
Medicare (plans)	$112,683	798%

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 $105,640.
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 Sharp Coronado Hospital and Hlthcr Ctr 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.