CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Montclair Hospital Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $19,343
  • Cash Discount Price: $19,342
  • vs. Medicare Baseline: 1.37x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Montclair Hospital Medical Center is $19,343. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19,342. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.37x the Medicare baseline. Located in 5000 San Bernardino Road, Montclair, CA.
Cash / Self-Pay
$19,342

Average discount available for prompt cash payment at this facility.

Insurance Median
$19,343

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: $19,342 (137%)
Insurance Median: $19,343 (137%)
Cash: $19,342 (137% of Medicare)
Ins. Median: $19,343 (137% 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
Alignment $19,222 136%
Central Health Plan $19,222 136%
Choice Physicians Network $19,222 136%
Elite Health Plan $19,222 136%
Emanate Health $19,222 - $38,686 136%
Epic Health Plan $19,222 - $27,080 136%
Health Net Of Ca $19,222 - $35,049 136%
Inland Empire Healthplan $19,222 - $24,179 136%
Medicare (plans) $19,222 - $19,343 136%
Molina $19,222 - $19,343 136%
Renal Payor Solution $19,222 136%
Vantage Care $19,222 136%
Inland Empire Foundation For Medical Care $19,343 137%
Tricare $19,343 - $20,065 137%
Brand New Day $19,415 138%
Neighborhood $19,607 139%
Imperial Health Plan Of Ca $20,376 144%
Health Net Federal Services Prison (Cdcr) $24,179 171%
Employer Direct Health Care $25,146 178%
Coventry Workers Compensation $29,006 205%
National Healthcare Solutions, Inc (Nhsi) $30,949 219%
Worker Compensation $35,209 249%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5000 San Bernardino Road, Montclair, CA 91763
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals