CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Madison County Health Care System

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $18,903
  • Cash Discount Price: $15,918
  • vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Madison County Health Care System is $18,903. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15,918. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.34x the Medicare baseline. Located in 300 West Hutchings Street, Winterset, IA.
Cash / Self-Pay
$15,918

Average discount available for prompt cash payment at this facility.

Insurance Median
$18,903

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: $15,918 (113%)
Insurance Median: $18,903 (134%)
Cash: $15,918 (113% of Medicare)
Ins. Median: $18,903 (134% 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
Madison County Sheriff-All Plans $9,949 70%
Blue Cross Blue Shield $10,745 76%
Aetna $12,934 - $26,082 92%
Corvel Wc-All Plans $17,908 127%
UnitedHealthcare $17,908 - $34,658 127%
Choicecare-All Plans $18,903 134%
First Choice-All Plans $18,903 134%
First Health-All Plans $18,903 134%
Integrated Hp-All Plans $18,903 134%
Mutual Of Omaha-All Plans $18,903 134%
Plaines Health-All Plans $18,903 134%
Preferred Hlth Ntwork-All Plans $18,903 134%
Principal Healthcare-All Plans $18,903 134%
Usa Managed Care-All Plans $18,903 134%
Medimore Employee Hp - All Plans $19,500 138%
Midlands Choice - All Plans $19,500 138%
Benefit Admin Of America-All Plans $19,898 141%
Tricare $19,898 141%
Medical Associates Hp - All Plans $26,082 185%
Medigold-All Plans $26,082 185%
American Hp Mcr Adv-All Plans $27,386 194%
Iowa Total Care Mcaid-All Plans $34,658 246%
Molina Mcaid/Chip -All Plans $35,871 254%
Amerigroup Mcaid-All Plans $36,390 258%
Oscar - All Plans $39,123 277%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 West Hutchings Street, Winterset, IA 50273
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals