CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Mercyone Clinton Medical Center

Billing Code: 871 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$16,550

about 1.2× the $14,117 Medicare rate · typically $15,544–$21,358

modeled estimate · not a bill or quote

What this hospital charges insurers

$20,749

Above the fair price

about $4,199 over the fair price · 1.5× Medicare

Medicare pays $14,117 Fair price $16,550 This hospital $20,749 Cash price $22,917

How we calculate the fair BaseRate →

How this hospital compares to other IA hospitals

Highest price of the 9 IA hospitals we have prices for — worth calling around.

Cheapest $13,069 Priciest $20,749

Black dot = this hospital, among the 9 IA hospitals with a price for this procedure. Full list below.

A fair price for a Sepsis treatment (inpatient stay) is about $16,550 (about 1.2× the $14,117 Medicare rate). Mercyone Clinton Medical Center charges insurers about $20,749, or about $22,917 in cash — above the fair price. Located in Clinton, IA.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $16,550. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$14,636 - $38,446	104%
Blue Cross Blue Shieldmajor	$14,493	103%
Aetnamajor	$14,349	102%
Ambetter (Centene)	$24,599	174%
GEHA	$38,446	272%
Oscar Health	$20,749	147%
+ 4 smaller / regional plans	$12,476 - $29,431

Government programs also on file: Medicare, Medicaid.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 22,917), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 871.

Insurance Before you use insurance

Call your insurance company to confirm Mercyone Clinton Medical Center is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 871.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Mercyone Clinton Medical Center

Compare: Sepsis treatment (inpatient stay) at other IA hospitals

Henry County Health Center · Mount Pleasant $13,069
Mary Greeley Medical Center · Ames $13,504
Grinnell Regional Medical Center · Grinnell $13,643
University of Iowa Health Care Medical Center Down · Iowa City $14,198
St Lukes Hospital · Cedar Rapids $14,587
Allen Hospital · Waterloo $14,749
Mercyone Oelwein Medical Center · Oelwein $15,131
Spencer Municipal Hospital · Spencer $15,325

Insurance negotiated median for the same procedure, sorted lowest first.