CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Caromont Regional Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $23,208
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.64x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Caromont Regional Medical Center is $23,208. 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 1.64x the Medicare baseline. Located in 2525 Court Dr, Gastonia, NC.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$23,208

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: $23,208 (164%)
Ins. Median: $23,208 (164% 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 $15,932 - $38,034 113%
UnitedHealthcare $15,932 113%
Aetna $16,569 - $38,238 117%
Devoted Health $16,728 118%
Healthteam $16,728 118%
Humana $16,728 118%
Longevity Health $16,728 118%
Molina $16,728 118%
Carolina Complete Health $22,753 161%
Alliance Behavioral Health $23,208 164%
Amerihealth Caritas $23,208 164%
Carolina Complete Health Tailored Plans $23,208 164%
Vaya Behavioral Health $23,208 164%
Wellcare $23,208 164%
Corporate Benefits Service $27,764 197%
Cigna $29,633 - $39,190 210%
Carolina Caring $39,829 282%
Gaston County Jail $45,506 322%
Medcost $46,702 331%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2525 Court Dr, Gastonia, NC 28052
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals