CMS Price Transparency Data
Sepsis treatment (inpatient stay)
Facility: Morristown Medical Center
Billing Code: 871 (MS-DRG)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 871
- Insurance Median: $45,536
- Cash Discount Price: $23,370
- vs. Medicare Baseline: 3.23x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Morristown Medical Center is $45,536. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23,370. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 3.23x the Medicare baseline. Located in 100 Madison Ave, Morristown, NJ.
Cash / Self-Pay
$23,370
Average discount available for prompt cash payment at this facility.
Insurance Median
$45,536
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: $23,370 (166%)
Insurance Median: $45,536 (323%)
Cash: $23,370 (166% of Medicare)
Ins. Median: $45,536 (323% 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 323% of the Medicare baseline (a markup of 223%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Occunet [5490] | $7,532 | 53% |
| The Fairly Group [5528] | $7,532 | 53% |
| Praxis Workers Comp [5515] | $8,500 | 60% |
| Inservco Workers Compensation [5158] | $8,682 | 62% |
| Medlogix/Consumer Health Network (Chn) [5415] | $8,682 | 62% |
| Gallagher Bassett Workers Comp [5117] | $9,028 | 64% |
| Liberty Mutual Worker's Comp [5174] | $9,028 | 64% |
| Pma Workers Comp [5224] | $9,028 | 64% |
| Sedgwick [5235] | $9,028 | 64% |
| Sentry Worker's Comp [5489] | $9,028 | 64% |
| Travelers Workers Compensation [5250] | $9,028 | 64% |
| Karen Ann Quinlan [5285] | $14,957 | 106% |
| Champva [5354] | $14,971 | 106% |
| Tricare | $14,971 | 106% |
| Us Family Health Plan [5258] | $14,971 | 106% |
| Aetna | $15,267 - $48,697 | 108% |
| Blue Cross Blue Shield | $16,963 - $48,288 | 120% |
| Cigna | $16,963 - $50,090 | 120% |
| Medicare (plans) | $16,963 - $85,626 | 120% |
| Amerihealth Administrators Supplemental [5512] | $17,302 | 123% |
| Amerihealth Medigap [5049] | $17,302 | 123% |
| Qualcare [5026] | $17,686 - $44,275 | 125% |
| Wellcare Behavioral Health [5335] | $18,150 | 129% |
| Wellcare Health Plans Ip Splits [5475] | $18,150 | 129% |
| Wellcare Health Plans [5269] | $18,150 | 129% |
| Highmark Wholecare Health Plan Ip Splits [5464] | $18,659 | 132% |
| Highmark Wholecare Health Plan [5413] | $18,659 | 132% |
| UPMC [5455] | $18,659 | 132% |
| VA Community Care Network [5403] | $18,696 | 132% |
| Kindred Giralda Hospital [5341] | $20,565 | 146% |
| Cosmetic Surgery/Lap Band/Gastric Bypass [5289] | $21,500 | 152% |
| Medicaid / KanCare | $21,500 | 152% |
| Specialty Imaging [5433] | $21,500 | 152% |
| Sedgwick Wtc Health Program Wc [5514] | $23,370 | 166% |
| Wtc Health Program [5273] | $24,928 | 177% |
| Claim Watcher/Homestead [5488] | $32,230 | 228% |
| Fairos [5491] | $35,709 | 253% |
| Ambetter / Centene | $38,513 | 273% |
| Claimdoc [5434] | $41,318 - $85,626 | 293% |
| Ghi Emblem Health [5122] | $44,275 - $85,626 | 314% |
| Humana | $44,275 | 314% |
| Ila Local 1478-2 Welfare Fund [5448] | $44,275 | 314% |
| Oscar [5213] | $44,275 | 314% |
| Evolution Healthcare [5438] | $45,536 - $48,697 | 323% |
| Healthez [5445] | $45,536 - $48,697 | 323% |
| Mvp Health Care [5197] | $45,536 | 323% |
| Nalc [5198] | $45,536 | 323% |
| Tufts Health Plan [5344] | $45,536 | 323% |
| Webtpa [5447] | $45,536 - $48,697 | 323% |
| Centivo [5405] | $46,003 - $50,090 | 326% |
| Independence Bc [5479] | $48,288 | 342% |
| Prime Healthcare [5435] | $48,288 | 342% |
| 1199 Seiu Benefit and Pension [5037] | $48,697 | 345% |
| Allied Benefit Systems [5046] | $48,697 - $50,090 | 345% |
| Banner Health Network [5510] | $48,697 | 345% |
| Boon-Chapman [5441] | $48,697 | 345% |
| Christian Brothers Services [5439] | $48,697 | 345% |
| Continental Assurance [5091] | $48,697 | 345% |
| Healthsmart Benefit Solutions [5446] | $48,697 | 345% |
| Luminare Health Benefits [5483] | $48,697 | 345% |
| Marpai Health [5449] | $48,697 | 345% |
| Meritain Health [5185] | $48,697 | 345% |
| Nippon Benefit Life [5201] | $48,697 | 345% |
| Starmark [5240] | $48,697 | 345% |
| Iaa - Insurance Administrators of America [5482] | $50,090 | 355% |
| Oxford Behavioral Health [5291] | $50,691 | 359% |
| Oxford [5024] | $50,691 | 359% |
| UnitedHealthcare | $50,691 - $52,261 | 359% |
| Apwu Healthcare [5053] | $52,261 | 370% |
| Geha [5119] | $52,261 | 370% |
| Golden Rule Insurance [5124] | $52,261 | 370% |
| Harvard Pilgrim Healthcare [5133] | $52,261 | 370% |
| Ntca [5208] | $52,261 | 370% |
| Surest [5437] | $52,261 | 370% |
| Bankers Life & Casualty Supplemental [5058] | $85,626 | 607% |
| Bollinger [5065] | $85,626 | 607% |
| Concern Non Employee [5086] | $85,626 | 607% |
| Continental Casualty [5093] | $85,626 | 607% |
| Generic Commercial [5015] | $85,626 | 607% |
| Generic No Fault [5017] | $85,626 | 607% |
| Health Net [5137] | $85,626 | 607% |
| Kessler Institute for Rehab [5166] | $85,626 | 607% |
| Magellan [5176] | $85,626 | 607% |
| Mutual of Omaha [5195] | $85,626 | 607% |
| Out of Country Insurance Plan [5215] | $85,626 | 607% |
| Runnells Specialized Hospital [5233] | $85,626 | 607% |
| The Health Plan [5451] | $85,626 | 607% |
| Work Med [5271] | $85,626 | 607% |