CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: USC Arcadia Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $19,930
Cash Discount Price: $19,300
vs. Medicare Baseline: 1.41x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at USC Arcadia Hospital is $19,930. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19,300. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.41x the Medicare baseline. Located in 300 W Huntington Dr, Arcadia, CA.

Cash / Self-Pay

$19,300

Average discount available for prompt cash payment at this facility.

Insurance Median

$19,930

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: $19,300 (137%)

Insurance Median: $19,930 (141%)

Cash: $19,300 (137% of Medicare)

Ins. Median: $19,930 (141% 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
Blue Cross Blue Shield	$4,214 - $19,930	30%
UnitedHealthcare	$4,560 - $19,930	32%
Cigna	$4,795 - $6,144	34%
Aetna	$5,600 - $19,930	40%
Blue Shield	$19,341 - $47,904	137%
Phcs	$19,636	139%
Caremore	$19,930	141%
Central Health	$19,930	141%
Citizen Choice	$19,930	141%
Easy Choice	$19,930	141%
Healthnet	$19,930 - $30,810	141%
Humana	$19,930	141%
Intervalley	$19,930	141%
Kaiser	$19,930	141%
La Care	$19,930	141%
Molina	$19,930 - $20,912	141%
Non Contracted	$19,930	141%
Regal Medical Group	$19,930 - $27,784	141%
Scan	$19,930	141%
Health Sharing Ministry	$23,363	165%
Healthcare Partners	$23,700	168%
Mhsc Employee Insurance	$27,784	197%
Hst Technology	$29,748	211%

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 $19,300.
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 Arcadia 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.