CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Madison County Health Care System

Billing Code: 871 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$20,675

about 1.5× the $14,117 Medicare rate · typically $11,652–$26,705

modeled estimate · not a bill or quote

Medicare pays $14,117 Fair price $20,675 Cash price $15,918 Hospital's list price $19,898

How we calculate the fair BaseRate →

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	$17,908 - $34,658	127%
Blue Cross Blue Shieldmajor	$10,745	76%
Aetnamajor	$12,934 - $26,082	92%
Amerigroup	$36,390	258%
Molina	$35,871	254%
Oscar Health	$39,123	277%
+ 14 smaller / regional plans	$9,949 - $34,658

Government programs also on file: Military & VA.

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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 15,918), 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 Madison County Health Care System 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 Madison County Health Care System

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.