CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Holland Community Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $27,602
Cash Discount Price: $27,700
vs. Medicare Baseline: 1.96x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Holland Community Hospital is $27,602. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27,700. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.96x the Medicare baseline. Located in 602 Michigan Ave, Holland, MI.

Cash / Self-Pay

$27,700

Average discount available for prompt cash payment at this facility.

Insurance Median

$27,602

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: $27,700 (196%)

Insurance Median: $27,602 (196%)

Cash: $27,700 (196% of Medicare)

Ins. Median: $27,602 (196% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Life Circles-All Plans	$12,978	92%
Health Alliance Mcr Adv	$14,420	102%
Ph Mcr Adv	$14,420	102%
UnitedHealthcare	$14,420 - $23,116	102%
Va Ccn - All Plans	$14,420	102%
Aetna	$14,853 - $36,933	105%
Longevity Health Plan-All Plans	$15,574	110%
Molina Mcaid - All Plans	$18,420	130%
Ph Mcaid	$18,420	130%
Nomi Health - All Plans	$23,698	168%
Sisco Epi	$27,128	192%
Sisco-All Other Plans	$27,128	192%
Cigna	$28,077	199%
Health Alliance Hmo	$31,061	220%
Cofinity -All Plans	$32,317	229%
Asr - All Plans	$32,473	230%
Health Alliance Ahl - All Other Plans	$32,473	230%
Priority Health - All Other Plans	$32,819	232%
Blue Cross Blue Shield	$32,863	233%
Multiplan - All Plans	$40,165	285%
Benefit Source Inc-All Plans	$41,550	294%
First Health-All Plans	$41,550	294%
Usa Managed Care-All Plans	$41,550	294%
Integrated Health Plans-All Plans	$43,858	311%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $27,700.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 871.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Holland Community Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 871.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.