CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Transylvania Regional Hospital, Inc

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $2,004
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.14x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Transylvania Regional Hospital, Inc is $2,004. 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 0.14x the Medicare baseline. Located in 90 Hospital Drive Po Box 1116, Brevard, NC.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,004

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: $2,004 (14%)
Ins. Median: $2,004 (14% 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
Carepartners Hospice $1,527 11%
Aetna $1,909 14%
Apex Health $1,909 14%
Alignment Health $1,947 14%
Devoted Health $1,947 14%
Cigna $1,966 14%
Humana $1,966 - $1,985 14%
Wellcare $1,966 - $22,200 14%
Nhc Advantage $1,985 14%
Healthteam Advantage $2,004 14%
Provider Partners Health Plan $2,004 14%
Pruitthealth Premier $2,004 14%
Troy Healthcare $2,004 14%
Blue Cross Blue Shield $2,021 - $21,553 14%
Longevity Health Plan $2,043 14%
Amerihealth Caritas $2,176 15%
United $2,408 17%
Vaya Health $22,200 157%
Amerihealth $22,415 159%
Partners Health Management $22,631 160%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 90 Hospital Drive Po Box 1116, Brevard, NC 28712
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals