CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Central Montana Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $18,170
  • Cash Discount Price: $16,430
  • vs. Medicare Baseline: 1.29x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Central Montana Medical Center is $18,170. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16,430. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.29x the Medicare baseline. Located in 408 Wendell Ave, Lewistown, MT.
Cash / Self-Pay
$16,430

Average discount available for prompt cash payment at this facility.

Insurance Median
$18,170

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: $16,430 (116%)
Insurance Median: $18,170 (129%)
Cash: $16,430 (116% of Medicare)
Ins. Median: $18,170 (129% 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 $6,822 - $19,330 48%
Humana $6,822 48%
Triwest - All Plans $6,822 48%
Veterans Affairs - All Plans $6,822 48%
Coventry/First Health - All Plans $17,977 127%
UnitedHealthcare $17,977 127%
Ebms - All Plans $18,363 130%
Allegiance Comm - All Other Plans $18,557 131%
Health Infonet - All Plans $18,557 131%
Montana Health Co-Op - All Plans $18,750 133%
Interwest Ppo $18,943 134%
Pacific Source Hp - All Plans $18,943 134%
Interwest Trad - All Other Plans $19,330 137%
Allegiance Rbphp $45,216 320%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 408 Wendell Ave, Lewistown, MT 59457
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals