CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Mainehealth Pen Bay Hospital

Billing Code: 871 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$17,596

about 1.2× the $14,117 Medicare rate · typically $14,255–$25,469

modeled estimate · not a bill or quote

What this hospital charges insurers

$20,275

Above the fair price

about $2,679 over the fair price · 1.4× Medicare

Medicare pays $14,117 Fair price $17,596 This hospital $20,275

How we calculate the fair BaseRate →

How this hospital compares to other ME hospitals

A typical price — 3 charge more and 4 charge less, among the 8 ME hospitals compared.

Cheapest $10,303 Priciest $25,239

Black dot = this hospital, among the 8 ME hospitals with a price for this procedure. Full list below.

A fair price for a Sepsis treatment (inpatient stay) is about $17,596 (about 1.2× the $14,117 Medicare rate). Mainehealth Pen Bay Hospital charges insurers about $20,275 — above the fair price. Located in Rockport, ME.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $17,596. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$19,975	141%
Blue Cross Blue Shieldmajor	$20,175 - $39,825	143%
Aetnamajor	$20,374	144%
Humanamajor	$19,975	141%
WellCare	$20,574	146%

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 871.

Insurance Before you use insurance

Call your insurance company to confirm Mainehealth Pen Bay Hospital is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 871.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Mainehealth Pen Bay Hospital

Compare: Sepsis treatment (inpatient stay) at other ME hospitals

Bridgton Hospital · Bridgton $10,303
Mainehealth Mid Coast Hospital · Brunswick $14,684
Mainehealth Maine Medical Center · Portland $17,284
Cary Medical Center · Caribou $17,570
Central Maine Medical Center · Lewiston $21,604
Rumford Hospital · Rumford $22,900
St Mary's Regional Medical Center · Lewiston $25,239

Insurance negotiated median for the same procedure, sorted lowest first.