CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Adventist Health Ukiah Valley

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $61,415
Cash Discount Price: $17,724
vs. Medicare Baseline: 4.35x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Adventist Health Ukiah Valley is $61,415. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17,724. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 4.35x the Medicare baseline. Located in 275 Hospital Drive, Ukiah, CA.

Cash / Self-Pay

$17,724

Average discount available for prompt cash payment at this facility.

Insurance Median

$61,415

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: $17,724 (126%)

Insurance Median: $61,415 (435%)

Cash: $17,724 (126% of Medicare)

Ins. Median: $61,415 (435% 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 435% of the Medicare baseline (a markup of 335%). 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
Mendocino Lcc District-All Plans	$7,505	53%
Interplan-All Plans	$8,450	60%
Blue Shield Mcr Adv	$22,284	158%
Kaiser Mcr Adv	$22,284	158%
Tricare	$22,284	158%
UnitedHealthcare	$22,284 - $68,717	158%
Kaiser Medi-Cal	$27,792	197%
Medi-Cal	$27,792	197%
Ah Employee Health Plan - All Plans	$40,112	284%
Blue Shield Epn-All Other Plans	$48,315	342%
Blue Shield Non-Epn	$49,620	351%
Healthnet-All Plans	$50,691	359%
Western Growers-All Plans	$50,860	360%
Blue Cross Blue Shield	$55,455 - $75,385	393%
Coventry-All Plans	$61,415	435%
Aetna	$65,247	462%
Foundation For Medical Care-All Plans	$66,466	471%
Cigna	$69,106	490%
Kaiser-All Other Plans	$70,897	502%
Networks By Design-All Plans	$70,897	502%
Phcs Multiplan-All Plans	$70,897	502%
Beech Street-All Plans	$75,328	534%
Choice Care-All Plans	$75,328	534%
Health Mgmt Network-All Plans	$75,328	534%
Three Rivers-All Plans	$79,759	565%

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 $17,724.
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 Ukiah Valley 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.