CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Coalinga Regional Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $23,370
  • Cash Discount Price: $20,240
  • vs. Medicare Baseline: 1.66x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Coalinga Regional Medical Center is $23,370. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20,240. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.66x the Medicare baseline. Located in 1191 Phelps Avenue, Coalinga, CA.
Cash / Self-Pay
$20,240

Average discount available for prompt cash payment at this facility.

Insurance Median
$23,370

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: $20,240 (143%)
Insurance Median: $23,370 (166%)
Cash: $20,240 (143% of Medicare)
Ins. Median: $23,370 (166% 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
Healthnet Mcal $12,000 85%
Blue Cross Blue Shield $15,276 - $24,300 108%
Medi-Cal $17,794 126%
Healthnet Hmo/Ppo - All Other Plans $21,000 149%
Cigna $23,370 166%
Healthnet Mcr Adv $24,300 172%
Aetna $28,674 203%
Department Of State Hosp - All Plans $31,590 224%
Healthnet Prison $31,590 224%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1191 Phelps Avenue, Coalinga, CA 93210
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals