CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Sampson Regional Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $16,166
  • Cash Discount Price: $23,692
  • vs. Medicare Baseline: 1.15x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Sampson Regional Medical Center is $16,166. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23,692. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.15x the Medicare baseline. Located in 607 Beaman St, Clinton, NC.
Cash / Self-Pay
$23,692

Average discount available for prompt cash payment at this facility.

Insurance Median
$16,166

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: $23,692 (168%)
Insurance Median: $16,166 (115%)
Cash: $23,692 (168% of Medicare)
Ins. Median: $16,166 (115% 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
UnitedHealthcare $7,023 - $16,166 50%
Cigna $9,588 68%
Multiplan - All Plans $10,800 77%
Healthy Blue Mcaid - All Plans $12,791 91%
Wellcare Mcaid - All Plans $12,791 91%
Blue Cross Blue Shield $15,849 112%
Liberty Adv - All Plans $16,166 115%
Aetna $16,482 - $30,461 117%
Gateway Mcr Adv - All Plans $16,482 117%
Medicare (plans) $17,433 123%
Prime/Travelers/Three Rivers - All Plans $17,433 123%
Medcost - All Plans $26,129 185%
Bc Nc Indemnity Ip/Op Only $33,845 240%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 607 Beaman St, Clinton, NC 28328
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals