CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Union Hospital Clinton

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $3,589
  • Cash Discount Price: $5,283
  • vs. Medicare Baseline: 0.25x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Union Hospital Clinton is $3,589. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,283. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 0.25x the Medicare baseline. Located in 801 S Main St, Clinton, IN.
Cash / Self-Pay
$5,283

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,589

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: $5,283 (37%)
Insurance Median: $3,589 (25%)
Cash: $5,283 (37% of Medicare)
Ins. Median: $3,589 (25% 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
Aetna $3,589 25%
Blue Cross Blue Shield $3,589 25%
Caresource $3,589 - $6,101 25%
Champva $3,589 25%
Cigna $3,589 25%
Coventry $3,589 25%
Humana $3,589 25%
Medicare (plans) $3,589 25%
Naphcare $3,589 25%
Tricare $3,589 25%
Umwa $3,589 25%
UnitedHealthcare $3,589 25%
Va Hospital $3,589 25%
Indiana Dept Of Corrections $3,733 26%
Iu Health Plans $5,563 39%
Ambetter / Centene $6,353 45%
Health Alliance $29,567 209%
Encore $29,942 212%
Sagamore $32,934 233%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 801 S Main St, Clinton, IN 47842
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals