CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Trinity Health Oakland Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $28,970
  • Cash Discount Price: $31,301
  • vs. Medicare Baseline: 2.05x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Trinity Health Oakland Hospital is $28,970. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $31,301. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 2.05x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.
Cash / Self-Pay
$31,301

Average discount available for prompt cash payment at this facility.

Insurance Median
$28,970

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: $31,301 (222%)
Insurance Median: $28,970 (205%)
Cash: $31,301 (222% of Medicare)
Ins. Median: $28,970 (205% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 205% of the Medicare baseline (a markup of 105%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Health Cost Solutions $2,000 14%
Vitalcore $2,000 14%
Wellpath $2,000 14%
Aetna $14,240 - $28,970 101%
Blue Care Network Advantage $14,240 101%
Blue Cross Blue Shield $14,240 - $32,898 101%
Medicare (plans) $14,240 - $14,530 101%
Align Senior Care $14,530 103%
UnitedHealthcare $14,966 106%
Cca - Zing Health $15,379 109%
Longevity Ipa Of Michigan Llc Health Plan Isnp $16,376 116%
Employee Benefit Logistic $17,288 122%
Molina Marketplace $18,889 134%
U Of M Health Plan $27,350 194%
Priority Health $28,441 - $31,601 201%
Geha $28,970 205%
Medical Mutual $28,970 205%
Meritain $28,970 205%
Asr Health Benefits $31,785 225%
Caresource $31,785 225%
Hap $31,785 225%
Varipro $31,785 225%
Bcn Domestic $32,898 233%
Blue Benefit Administrators Of Massachusetts $32,898 233%
Blue Care Network $32,898 233%
Blue Distinction Transplant $32,898 233%
Blue Shield - Ca $32,898 233%
Blue Shield - Id (Regence) $32,898 233%
Blue Shield - Ny Highmark Northeastern $32,898 233%
Blue Shield - Ny Highmark Western $32,898 233%
Blue Shield - Pa (Highmark) $32,898 233%
Blue Shield - Wa (Regence) $32,898 233%
Health Choices $32,898 233%
Kaiser Domestic $32,898 233%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 44405 Woodward Ave, Pontiac, MI 48341
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals