CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Adventist Health Tehachapi Valley

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $28,357
Cash Discount Price: $19,310
vs. Medicare Baseline: 2.01x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Adventist Health Tehachapi Valley is $28,357. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19,310. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 2.01x the Medicare baseline. Located in 1100 Magellan, Tehachapi, CA.

Cash / Self-Pay

$19,310

Average discount available for prompt cash payment at this facility.

Insurance Median

$28,357

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: $19,310 (137%)

Insurance Median: $28,357 (201%)

Cash: $19,310 (137% of Medicare)

Ins. Median: $28,357 (201% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 201% of the Medicare baseline (a markup of 101%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Cigna	$2,475	18%
Klhp-Kern Legacy Epo -All Other Plans	$6,256	44%
Blue Cross Blue Shield	$8,548 - $9,680	61%
Healthnet Medi-Cal	$8,572	61%
Blue Shield Epn- All Other Plans	$13,308	94%
Blue Shield Non-Epn	$16,688	118%
Oscar Health Plan- All Plans	$18,297	130%
Healthnet Mcare	$23,548	167%
Medicare (plans)	$23,548	167%
Tricare	$23,548	167%
UnitedHealthcare	$23,548 - $33,999	167%
Kaiser Medi-Cal Ip/Op Only	$28,357	201%
Medi-Cal	$28,357	201%
Bc Mcal	$29,207	207%
Aetna	$29,801	211%
Western Grwrs/Pinnacle - All Plans	$30,012	213%
Network Providers- All Plans	$30,141	214%
Healthnet- All Other Plans	$31,697	225%
Ah Employee Health Plan - All Plans	$37,904	269%
Khs-Kern Hlth Systm Mcal	$38,849	275%
Kaiser Ip/Op Only- All Other Plans	$40,503	287%
Coventry- All Plans	$51,493	365%
Centivo - All Plans	$52,983	375%

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 $19,310.
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 Tehachapi Valley 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.