CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Bluffton Regional Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $16,587
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Bluffton Regional Medical Center is $16,587. 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 1.17x the Medicare baseline. Located in 303 S Main St, Bluffton, IN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$16,587

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: $16,587 (117%)
Ins. Median: $16,587 (117% 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Lutheran Trma $11,218 - $14,277 79%
Ahg Dana Employees $13,015 92%
Lutheran Preferred Network $13,598 - $23,810 96%
UnitedHealthcare $14,031 - $15,873 99%
Aetna $15,590 110%
Blue Cross Blue Shield $15,590 - $31,861 110%
Medicare (plans) $15,590 110%
Node Iu Health Mcr Adv $15,590 110%
Node Mhs Mcr Adv $15,590 110%
Humana $15,873 112%
Node Caresource Mcr Adv $15,901 113%
Node Devoted Health Mcr Adv $15,901 113%
Node Va $16,190 115%
County Jail Health Care $16,508 117%
In Dept Of Correction $16,508 117%
Node Pphp Mcr Adv $16,667 118%
Physicians Health Plan $21,511 152%
Us Department Of Labor $22,840 162%
Php $23,423 166%
Lutheran Advanced Network $23,810 169%
Lutheran Three Rivers Preferred Plus 150 $23,810 169%
Encore Ppo $26,388 187%
Lutheran Three Rivers Preferred Plus 175 $27,778 197%
Php Freedom Network $28,364 201%
Encore Work Comp In $28,571 202%
Prime Health Services $28,571 202%
Lutheran Northwest Health Preferred $31,746 225%
Managed Health Services Exchange $31,746 225%
Workers Compensation $31,746 225%
Amish Aid $34,589 245%
Encore Kba Epo $38,095 270%
Encore Kba Ppo $47,619 337%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 303 S Main St, Bluffton, IN 46714
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals