CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Spectrum Health

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $18,436
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.31x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Spectrum Health is $18,436. 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 1.31x the Medicare baseline. Located in 100 Michigan St Ne, Grand Rapids, MI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$18,436

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: $18,436 (131%)
Ins. Median: $18,436 (131% 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
Blue Cross Blue Shield $17,558 - $46,145 124%
Care Resources $17,558 124%
Community Pace $17,558 124%
Health Alliance Plan $17,558 124%
Life Circles $17,558 124%
Mclaren Health Plan $17,558 124%
Priority Health $17,558 - $48,873 124%
Trinity Health Plan Of Michigan $17,558 124%
Aetna $18,436 131%
Molina Healthcare $18,436 - $31,605 131%
University Of Michigan Health Plan $18,436 131%
Meridian Health Plan $31,605 224%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Michigan St Ne, Grand Rapids, MI 49503
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals