CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Memorialcare Saddleback Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $26,081
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.85x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Memorialcare Saddleback Medical Center is $26,081. 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 1.85x the Medicare baseline. Located in 24451 Health Center Drive, Laguna Hills, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$26,081

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: $26,081 (185%)
Ins. Median: $26,081 (185% 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
Scan Health Plan $16,856 119%
Monarch Health Plan $17,219 - $38,787 122%
Blue Shield $17,762 - $38,786 126%
Aetna $18,125 - $100,685 128%
Alignment Health Plan $18,125 128%
Blue Cross Blue Shield $18,125 - $48,147 128%
Citizens Choice $18,125 128%
Healthnet $18,125 - $68,806 128%
Heritage Provider Network $18,125 128%
Humana $18,125 128%
La Care $18,125 128%
Onecare $18,125 128%
Seoul Medical Group $18,125 128%
UnitedHealthcare $18,125 - $67,028 128%
Clever Care $19,031 135%
Easy Choice $19,031 135%
Select Health $19,031 - $24,469 135%
Universal Care $19,031 135%
Central Health $19,937 141%
Cigna $33,239 - $52,250 235%
Centivo $40,781 289%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 24451 Health Center Drive, Laguna Hills, CA 92653
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals