CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: AHMC Seton Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $21,708
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.54x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at AHMC Seton Medical Center is $21,708. 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 1900 Sullivan Avenue, Daly City, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$21,708

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: $21,708 (154%)
Ins. Median: $21,708 (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.

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
Healthcare Foundation Of San Mateo $1,657 - $1,907 12%
San Mateo County/San Mateo County General Hospital $1,802 13%
Chinese Community Health Plan $2,578 - $21,708 18%
The First Health Network $2,700 19%
UnitedHealthcare $3,544 - $22,116 25%
Blue Cross Blue Shield $4,165 - $21,708 30%
Cigna $4,204 - $4,673 30%
Blue Shield Of California $4,494 - $35,053 32%
Ahmc Health $4,591 33%
Health Net $5,003 35%
Aetna $5,413 - $21,708 38%
Veterans Administration (Va) $15,481 110%
Care Advantage $21,708 154%
For Your Benefit $21,708 154%
Healthnet Seniority $21,708 154%
Humana $21,708 154%
Imperial Health Plan $21,708 154%
Jade Health Care Mg $21,708 154%
Medicare (plans) $21,708 154%
North East Medical Services $21,708 154%
Pacificare $21,708 154%
Canopy Health $22,116 - $49,761 157%
Covid-19 Uninsured Program $22,116 157%
Kaiser $22,116 157%
Easy Choice Hospital Services $22,337 158%
Brand New Day $23,445 - $27,645 166%
Central Health Plan $23,445 166%
Knox-Keene Act $27,645 196%
Workers Compensation Federal $30,704 217%
Athens Administrators $32,799 232%
Corvel Healthcare $32,799 232%
Multiplan/Bce Emergis $32,799 232%
Work Comp Other $32,799 232%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1900 Sullivan Avenue, Daly City, CA 94015
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals