Sepsis treatment (inpatient stay)
Facility: Central Valley Specialty Hospital
Billing Code: 871 (MS-DRG)
- CPT Billing Code: 871
- Insurance Median: $81,293
- Cash Discount Price: $111,751
- vs. Medicare Baseline: 5.76x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 576% of the Medicare baseline (a markup of 476%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medi-Cal Ip Only | $39,113 | 277% |
| Aetna | $39,200 - $116,547 | 278% |
| Cigna | $46,200 | 327% |
| Dmc Modesto Ip Only | $50,400 | 357% |
| Blue Cross Blue Shield | $51,156 - $58,930 | 362% |
| Alameda Alliance Mcal Ip Only - All Other Plans | $51,800 | 367% |
| Multiplan Ip Only-All Plans | $56,000 | 397% |
| Hp Of San Joaquin Mcal Ip Only-All Plans | $66,568 | 472% |
| Sutter Ip Only-All Plans | $67,200 | 476% |
| Healthnet Ip Only-All Other Plans | $69,484 | 492% |
| Healthnet Mcal Ip Only | $69,484 | 492% |
| Align Sr Care Ca Inc Ip Only-All Plans | $72,800 | 516% |
| Networks By Design Ip Only-All Plans | $72,934 | 517% |
| Sfhp Ip Only-All Plans | $78,400 | 555% |
| Healthnet Cdcr Mcr Ip Only | $81,293 | 576% |
| Stanislaus County Ip Only-All Plans | $84,134 | 596% |
| Kaiser Ip Only-All Plans | $86,741 | 614% |
| Dmc Tenet Sr Ip Only | $110,719 | 784% |
| Blue Shield Ip Only-All Other Plans | $112,710 | 798% |
| Alignment Hlth Plan Ip Only- All Plans | $116,547 | 826% |
| Blue Shield Mcr Ip Only | $116,547 | 826% |
| Family Hlth Care Ntwrk Pace Mcr Ip Only-All Plans | $116,547 | 826% |
| Health Partners Ip Only - All Plans | $116,547 | 826% |
| Healthnet Mcr Ip Only | $116,547 | 826% |
| Humana | $116,547 | 826% |
| Triwest Ip Only - All Plans | $116,547 | 826% |
| Dmc Tenet Ip Only-All Other Plans | $122,374 | 867% |
| Contra Costa Ip Only-All Plans | $124,147 | 879% |
| Correct Care Ip Only-All Plans | $134,029 | 949% |