CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Northwest Health - Porter

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $16,882
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.20x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Northwest Health - Porter is $16,882. 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 1.20x the Medicare baseline. Located in 85 East Us Hwy 6, Valparaiso, IN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$16,882

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: $16,882 (120%)
Ins. Median: $16,882 (120% 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
UnitedHealthcare $13,390 - $22,958 95%
Lutheran Preferred $14,154 - $30,284 100%
Humana $14,786 105%
Aetna $14,874 105%
Blue Cross Blue Shield $14,874 - $29,530 105%
Medicare (plans) $14,874 - $16,255 105%
Node Mhs Mcr Adv $14,874 105%
Healthy Indiana Plan $15,142 107%
Care Improvement Plus $15,618 111%
In Dept Of Correction $15,748 112%
Node Devoted Health Mcr Adv $16,580 117%
Node Va $16,882 120%
Node Us Dept Of Labor $23,744 168%
First Health Coventry $25,287 179%
Encore Health $27,255 193%
Preferred Network Access $27,255 193%
Prime Health $27,255 193%
Encore Ppo $28,555 202%
Indiana Work Comp $30,284 215%
Managed Health Services $33,103 234%
Porter County $36,341 257%
Node Encore Kba Epo $39,723 281%
Magnacare Ma $42,155 299%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 85 East Us Hwy 6, Valparaiso, IN 46383
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals