CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Adventist Health Howard Memorial

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $63,903
Cash Discount Price: $25,410
vs. Medicare Baseline: 4.53x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Adventist Health Howard Memorial is $63,903. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25,410. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 4.53x the Medicare baseline. Located in 1 Marcela Dr, Willits, CA.

Cash / Self-Pay

$25,410

Average discount available for prompt cash payment at this facility.

Insurance Median

$63,903

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: $25,410 (180%)

Insurance Median: $63,903 (453%)

Cash: $25,410 (180% of Medicare)

Ins. Median: $63,903 (453% 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 453% of the Medicare baseline (a markup of 353%). 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
Ah Employee Health Plan - All Plans	$26,257	186%
Medi-Cal	$34,448	244%
Tricare	$49,441	350%
Medicare (plans)	$49,935	354%
Western Growers/Pinnacle - All Plans	$53,046	376%
UnitedHealthcare	$54,385 - $65,542	385%
Blue Shield - All Other Plans	$55,395	392%
Blue Shield Epn	$55,395	392%
Aetna	$56,826	403%
First Health Ppo - All Plans	$67,761	480%
Ghn Ppo - All Plans	$67,761	480%
Healthnet - All Plans	$69,455	492%
Brms - All Plans	$71,996	510%
Cigna	$71,996	510%
Blue Cross Blue Shield	$182,386 - $199,679	1292%
Blue Shield Mcare	$189,023	1339%

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 $25,410.
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 Howard Memorial 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.