CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Decatur Memorial Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $15,625
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.11x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Decatur Memorial Hospital is $15,625. 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 1.11x the Medicare baseline. Located in 2300 North Edward Street, Decatur, IL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,625

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: $15,625 (111%)
Ins. Median: $15,625 (111% 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
Corvel $1,433 10%
Health Alliance $11,655 - $20,524 83%
Phcs Savility $11,871 84%
Mennonite Churches $12,041 85%
Hfn $12,820 - $31,296 91%
Plain Church Medical Group $12,882 91%
Humana $13,339 - $14,545 94%
Blue Cross Blue Shield $15,020 - $15,484 106%
Consociate $15,105 107%
Coventry $15,484 - $17,230 110%
UnitedHealthcare $15,484 - $42,016 110%
Wellcare $15,484 110%
Tricare $15,765 112%
Aetna $15,894 - $26,806 113%
Medicare (plans) $15,894 113%
Veterans Administration $15,894 113%
Healthlink $16,397 116%
Caterpillar $16,503 117%
Cigna $18,807 133%
Commercial Workers Compensation $31,629 224%
Illinois Workers Compensation $33,294 236%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2300 North Edward Street, Decatur, IL 62526
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals