CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Northside Hospital Duluth

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $8,589
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.61x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Northside Hospital Duluth is $8,589. 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 0.61x the Medicare baseline. Located in 3620 Howell Ferry Road, Duluth, GA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,589

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: $8,589 (61%)
Ins. Median: $8,589 (61% 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Blue Cross Blue Shield $3,245 - $19,751 23%
Kaiser $3,538 - $20,344 25%
Aetna $3,841 - $19,949 27%
Phcs $4,403 31%
Northside Health Network $4,623 33%
UnitedHealthcare $4,634 - $19,751 33%
Champus Va $5,868 42%
Tricare $5,879 42%
Cigna $6,294 - $20,344 45%
Genex/Priority Care Solutions $15,461 110%
Streamline Imaging $17,394 123%
Humana $18,050 - $19,949 128%
Coventry $18,229 - $20,146 129%
Corvel Workers Comp $18,360 130%
Employers Choice Network $18,360 130%
Wellcare $18,408 - $20,344 130%
Ambetter / Centene $18,765 - $37,314 133%
Pruitt Health Premier $18,765 - $20,739 133%
Clear Springs Eon Health $18,911 - $19,751 134%
Medicare (plans) $18,911 - $23,702 134%
Va Ccn $18,911 - $19,751 134%
Georgia Workers Compensation $19,327 137%
One Call Diagnostics $19,327 137%
Caresource $19,857 141%
Clover Health $19,857 141%
Amerigroup $20,541 - $22,991 146%
Georgia Reproductive Specialists $25,155 178%
Careiq $62,888 445%
Dekalb_Department Of Health $62,888 445%
Fifa $62,888 445%
Rabun County Boc $62,888 445%
Spreemo $62,888 445%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3620 Howell Ferry Road, Duluth, GA 30096
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals