CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Casa Colina Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $21,657
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.53x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Casa Colina Hospital is $21,657. 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 1.53x the Medicare baseline. Located in 255 E Bonita Ave, Pomona, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$21,657

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: $21,657 (153%)
Ins. Median: $21,657 (153% 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Heritage Prvdr Ntwrk Comm - All Other Plans $2,200 16%
Heritage Prvdr Ntwrk Mcr $2,200 16%
Primecare Chino Valley Mcr $2,200 16%
Aetna $2,356 - $22,148 17%
Primecare Chino Valley Comm $2,500 18%
Blue Cross Blue Shield $18,457 - $45,958 131%
Blue Shield Mcr Adv $18,457 131%
Brand New Day Mcr Adv - All Plans $18,457 131%
Caremore Mcr Adv - All Plans $18,457 131%
Central Hlth Plan - All Plans $18,457 131%
Healthnet Mcr Adv $18,457 131%
Humana $18,457 - $42,643 131%
Iehp - All Other Plans $18,457 131%
Iehp Mcr Adv $18,457 131%
Kaiser Mcr Adv $18,457 131%
UnitedHealthcare $18,457 - $21,917 131%
Wellcare Mcr Adv - All Plans $18,457 131%
Prospect Hp Mcal $18,511 131%
Epic Comm - All Other Plans $20,057 142%
Epic Mcr Adv $20,057 142%
Triwest - All Plans $20,157 143%
Prospect Hp Mcr Adv $20,657 146%
Primecare Mcr Adv $21,657 153%
Prospect Hp Comm - All Other Plans $22,803 162%
Healthcare Partners Mcr $24,457 173%
Blue Shield Comm - All Other Plans $24,565 174%
Affiliated Hlth Funds - All Plans $24,930 177%
Primecare Comm - All Other Plans $26,271 186%
Cigna $28,766 204%
Healthnet Comm - All Other Plans $28,900 205%
Healthcare Partners - All Other Plans $29,071 206%
Kaiser Comm - All Other Plans $34,631 245%
Heritage Prvdr Ntwrk Mcal $37,629 267%
Iehp Mcal $37,629 267%
Medi-Cal $37,629 267%
Kaiser Mcal $41,391 293%
Galaxy Provdr Ntwrk - All Plans $43,443 308%
Corvel - All Plans $50,039 354%
Coventry - All Plans $50,039 354%
Multiplan - All Plans $50,039 354%
Prospect Med Grp Alta - All Plans $53,700 380%
Three Rivers - All Plans $55,855 396%
Focus Healthcare Wc - All Plans $57,096 404%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 255 E Bonita Ave, Pomona, CA 91767
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals