CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Hca-Healthone DBA Swedish Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $16,810
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.19x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Hca-Healthone DBA Swedish Medical Center is $16,810. 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 1.19x the Medicare baseline. Located in 501 E Hampden Ave, Englewood, CO.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$16,810

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: $16,810 (119%)

Ins. Median: $16,810 (119% 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.

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
Physician Health Partners	$1,680 - $1,975	12%
Cigna	$2,090 - $42,002	15%
United	$2,330 - $16,222	17%
Kaiser	$3,200 - $17,146	23%
Rocky Mountain Health Plan	$3,679 - $9,415	26%
Aetna	$5,738 - $16,810	41%
Blue Cross Blue Shield	$16,810 - $34,276	119%
Bright Health	$16,810	119%
Humana	$16,810	119%
Mutual Of Omaha	$16,810	119%
Rocky Mountain Health	$16,810	119%
Total Longterm Care	$16,810	119%
Triwest Health Alliance	$16,810	119%
Devoted Health	$17,146	121%
Delaware Life Insurance	$17,314	123%
Wellcare	$17,314	123%
Pinnacol Workers Comp	$23,497	166%
Multiplan	$24,487	173%

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 $X.
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 Hca-Healthone DBA Swedish Medical Center 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.