CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Adventist Health Delano

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $27,883
Cash Discount Price: $8,723
vs. Medicare Baseline: 1.98x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Adventist Health Delano is $27,883. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,723. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.98x the Medicare baseline. Located in 1401 Garces Highway, Delano, CA.

Cash / Self-Pay

$8,723

Average discount available for prompt cash payment at this facility.

Insurance Median

$27,883

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: $8,723 (62%)

Insurance Median: $27,883 (198%)

Cash: $8,723 (62% of Medicare)

Ins. Median: $27,883 (198% 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
Kern Health System Mcal	$11,676	83%
Gem Care- All Plans	$16,150	114%
County Of Kern Network - All Plans	$16,716	118%
Blue Shield Non-Epn	$19,885	141%
Bakersfield Fam Med Grp-All Plans	$21,082	149%
Healthnet Mcr Adv	$21,082	149%
Kern Mcr Adv Dual Dnsp-All Other Plans	$21,082	149%
Medicare (plans)	$21,082 - $33,731	149%
Tricare	$21,082	149%
UnitedHealthcare	$21,082 - $31,257	149%
Universal Care Mcr- All Other Plans	$21,082	149%
Healthnet- All Other Plans	$22,114	157%
Aetna	$24,616	174%
Coventry- All Plans	$26,170	185%
Blue Shield Epn - All Other Plans	$27,991	198%
Western Growers - All Plans	$30,277	214%
Kaiser Medi-Cal Ip/Op Only	$32,089	227%
Medi-Cal	$32,089	227%
Universal Care Mcal	$32,089	227%
Foundation For Medical Care Of Kern County - All Plans	$32,713	232%
Cigna	$34,894	247%
Kaiser Comm Ip/Op Only- All Other Plans	$36,261	257%
Blue Cross Blue Shield	$36,294 - $37,864	257%
Ah Employee Health Plan - All Plans	$37,947	269%
Centivo - All Plans	$47,434	336%

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 $8,723.
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 Delano 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.