CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Chino Valley Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $21,069
Cash Discount Price: $21,068
vs. Medicare Baseline: 1.49x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Chino Valley Medical Center is $21,069. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21,068. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.49x the Medicare baseline. Located in 5451 Walnut Ave, Chino, CA.

Cash / Self-Pay

$21,068

Average discount available for prompt cash payment at this facility.

Insurance Median

$21,069

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: $21,068 (149%)

Insurance Median: $21,069 (149%)

Cash: $21,068 (149% of Medicare)

Ins. Median: $21,069 (149% 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
Tricare	$19,856 - $21,299	141%
Alignment	$19,894	141%
Blue Shield Of Ca Triwest Healthcare Ccn	$19,894	141%
Choice Physicians Network	$19,894	141%
Emanate Health	$19,894 - $42,138	141%
Epic Health Plan	$19,894 - $29,497	141%
Health Net Of Ca	$19,894 - $38,177	141%
Inland Empire Health Plan	$19,894 - $26,336	141%
Molina	$19,894 - $21,069	141%
Prime Healthcare Services	$19,894 - $21,069	141%
Renal Payer Solutions	$19,894	141%
Vantage Care	$19,894	141%
Brand New Day	$20,093	142%
Neighborhood	$20,292	144%
Central Health Plan	$21,069	149%
Inland Empire Foundation For Medical Care	$21,069	149%
Medicare (plans)	$21,069	149%
Imperial Health Plan Of Ca	$21,087	149%
Health Net Federal Services Cdcr	$26,336	187%
Employer Direct Healthcare	$27,390	194%
Naphcare	$32,657	231%
Aetna	$33,080	234%
National Healthcare Solutions, Inc (Nhsi)	$33,710	239%
Worker Compensation	$34,103	242%

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 $21,068.
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 Chino Valley Medical Center 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.