CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Goshen Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $14,250
  • Cash Discount Price: $51,177
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Goshen Hospital is $14,250. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $51,177. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.01x the Medicare baseline. Located in 200 High Park Ave, Goshen, IN.
Cash / Self-Pay
$51,177

Average discount available for prompt cash payment at this facility.

Insurance Median
$14,250

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: $51,177 (363%)
Insurance Median: $14,250 (101%)
Cash: $51,177 (363% of Medicare)
Ins. Median: $14,250 (101% 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
Advantage Health Solutions $14,250 101%
Aetna $14,250 101%
Atrio Health Plans $14,250 101%
Bc Federal Employee $14,250 101%
Bc Mcr Advantage Ppo $14,250 101%
Blue Cross Blue Shield $14,250 - $44,598 101%
Buckeye Health Plan $14,250 101%
Champva $14,250 101%
Cigna $14,250 101%
Coventry Health And Life $14,250 101%
Emblem Health $14,250 101%
Freedom Healthcare $14,250 101%
Geisinger Health Plan $14,250 101%
Health First $14,250 101%
Healthspring $14,250 101%
Humana $14,250 101%
Iehp Empire Health Plan $14,250 101%
Independent Care Health Plan $14,250 101%
Kaiser Permanente $14,250 101%
Mcr Advantra Freedom $14,250 101%
Mcr Allwell Mhs $14,250 101%
Mcr Banner Health $14,250 101%
Mcr Complete $14,250 101%
Mcr Complete Ppo $14,250 101%
Mcr Complete Wellmed $14,250 101%
Mcr Health Alliance $14,250 101%
Mcr Health Partners Plans $14,250 101%
Mcr Medical Mutual Of Ohio $14,250 101%
Mcr Passport Advantage $14,250 101%
Mcr Secure Horizons Ppo $14,250 101%
Mcr Texan Plus $14,250 101%
Mcr Upmc For Life $14,250 101%
Medicare (plans) $14,250 - $14,677 101%
Meridian Complete $14,250 101%
Optimum Healthcare $14,250 101%
Paramount Elite $14,250 101%
Primetime Health Plan $14,250 101%
Simply Complete Hmo $14,250 101%
The Umwa H&R Funds $14,250 101%
Todays Options Pyramid Life $14,250 101%
Tricare $14,250 101%
Trillium Advantage $14,250 101%
Ucare For Seniors $14,250 101%
Ucare Minnesota $14,250 101%
UnitedHealthcare $14,250 101%
Wellcare $14,250 101%
Mcr Devoted Health Plan $14,677 104%
Mcr Provider Partners Hlth Pln $15,675 111%
Ambetter / Centene $19,949 141%
Mkt Caresource $19,949 141%
Qca/Cha Meritain $29,138 206%
Bc Allied $44,598 316%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 High Park Ave, Goshen, IN 46526
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals