CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Sartori Memorial Hospital, Inc

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $22,187
  • Cash Discount Price: $13,969
  • vs. Medicare Baseline: 1.57x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Sartori Memorial Hospital, Inc is $22,187. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13,969. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.57x the Medicare baseline. Located in 515 College Street, Cedar Falls, IA.
Cash / Self-Pay
$13,969

Average discount available for prompt cash payment at this facility.

Insurance Median
$22,187

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: $13,969 (99%)
Insurance Median: $22,187 (157%)
Cash: $13,969 (99% of Medicare)
Ins. Median: $22,187 (157% 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
Aetna $12,903 - $22,255 91%
Medicare (plans) $12,903 - $13,429 91%
Blue Cross Blue Shield $13,032 92%
UnitedHealthcare $13,161 - $29,132 93%
Iowa Total Care $13,910 99%
Medicaid / KanCare $14,046 - $14,100 99%
Oscar $17,096 121%
Amish Hospital Aid $17,511 124%
Centivo $21,856 155%
Ambetter / Centene $22,119 157%
Allied Benefit Systems $22,255 158%
Asr Health Benefits $22,255 158%
Coventry $22,255 158%
First Health $22,255 158%
Lucent Health $22,255 158%
Luminare Health $22,255 158%
Medical Mutual $22,255 158%
Meritain $22,255 158%
Webtpa $22,255 158%
Claimdoc $26,464 187%
Nova $26,464 187%
Geha $29,132 206%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 515 College Street, Cedar Falls, IA 50613
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals