CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Sterling Regional Medcenter

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $23,491
Cash Discount Price: $25,723
vs. Medicare Baseline: 1.66x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Sterling Regional Medcenter is $23,491. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25,723. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.66x the Medicare baseline. Located in 615 Fairhurst St, Sterling, CO.

Cash / Self-Pay

$25,723

Average discount available for prompt cash payment at this facility.

Insurance Median

$23,491

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: $25,723 (182%)

Insurance Median: $23,491 (166%)

Cash: $25,723 (182% of Medicare)

Ins. Median: $23,491 (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.

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
Pinnacol Assurance Workers Comp	$17,304	123%
Aetna	$23,491	166%
Banner Health	$23,491	166%
Blue Cross Blue Shield	$23,491	166%
Clear Spring Health	$23,491	166%
Healthspring Life & Health Insurance Company, Inc.	$23,491	166%
Medica	$23,491	166%
Medicare (plans)	$23,491	166%
UnitedHealthcare	$23,491	166%
Longevity	$24,195	171%
Humana	$24,900	176%
Devoted Health Services	$25,840	183%
Denver Health Medical Plan	$45,880	325%

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 $25,723.
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 Sterling Regional Medcenter 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.