CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Astera Health

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $17,390
Cash Discount Price: $20,914
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Astera Health is $17,390. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20,914. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.23x the Medicare baseline. Located in 421 11Th Street Nw, Wadena, MN.

Cash / Self-Pay

$20,914

Average discount available for prompt cash payment at this facility.

Insurance Median

$17,390

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: $20,914 (148%)

Insurance Median: $17,390 (123%)

Cash: $20,914 (148% of Medicare)

Ins. Median: $17,390 (123% 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
Ucare Pmap [30006]	$1,688	12%
Blue Cross Blue Shield	$5,128 - $22,921	36%
Blue Plus Pmap [40002]	$5,128 - $5,868	36%
Health Partners [10045]	$5,128	36%
Medica Nonpmap [10056]	$5,128 - $23,478	36%
Primewest Non Pmap [30004]	$5,128	36%
Ucare Non Pmap [30007]	$5,385	38%
Ucare Commercial [10705]	$20,914	148%
UnitedHealthcare	$22,393	159%
Multiplan	$24,111	171%
Sanford Health Plan [10120]	$25,618	181%
Aetna	$27,125	192%

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 $20,914.
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 Astera Health 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.