CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Ascension River District Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $12,276
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.87x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Ascension River District Hospital is $12,276. 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 0.87x the Medicare baseline. Located in 4100 River Rd, East China, MI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$12,276

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: $12,276 (87%)
Ins. Median: $12,276 (87% 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
Humana $8,400 - $12,399 60%
Aetna $9,410 - $12,276 67%
Phcs Pos $9,410 67%
Phcs Ppo $9,410 67%
UnitedHealthcare $10,828 77%
Medicare (plans) $11,662 - $12,890 83%
Amerihealth Vip Care $12,153 86%
Great Lakes Health Plan $12,276 87%
Harbor Advantage Hmo $12,276 87%
Tricare $12,276 87%
Veterans Choice $12,276 87%
Total Health Care $12,399 88%
Meridian Wellcare $12,890 91%
Molina Advantage $12,890 91%
Molina Health Link $12,890 91%
Ambetter / Centene $15,345 109%
Molina Market Place $15,345 109%
Smarthealth $17,187 122%
Ppom $19,215 136%
Aaa-Auto Insurance $23,325 165%
Priority Hmo $23,808 169%
Priority Ppo $23,808 169%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4100 River Rd, East China, MI 48054
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals