CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Riverview Medical Center

Billing Code: 871 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$23,549

about 1.7× the $14,117 Medicare rate · typically $17,800–$37,917

modeled estimate · not a bill or quote

What this hospital charges insurers

$17,977

Below the fair price — a good deal

about $5,572 under the fair price · 1.3× Medicare

Medicare pays $14,117 Fair price $23,549 This hospital $17,977 Cash price $16,645

How we calculate the fair BaseRate →

How this hospital compares to other NJ hospitals

A typical price — 5 charge more and 3 charge less, among the 9 NJ hospitals compared.

Cheapest $15,248 Priciest $19,869

Black dot = this hospital, among the 9 NJ hospitals with a price for this procedure. Full list below.

A fair price for a Sepsis treatment (inpatient stay) is about $23,549 (about 1.7× the $14,117 Medicare rate). Riverview Medical Center charges insurers about $17,977, or about $16,645 in cash — below the fair price — a good deal. Located in Red Bank, NJ.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$16,272 - $74,173	115%
Blue Cross Blue Shieldmajor	$15,498	110%
Aetnamajor	$15,498 - $54,733	110%
Cignamajor	$53,226 - $59,220	377%
Amerigroup	$15,498	110%
AmeriHealth	$13,697	97%
Clover Health	$17,047	121%
WellCare	$15,498	110%
+ 6 smaller / regional plans	$13,307 - $63,529

Government programs also on file: Military & VA.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 16,645), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 871.

Insurance Before you use insurance

Call your insurance company to confirm Riverview Medical Center is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 871.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Riverview Medical Center

Compare: Sepsis treatment (inpatient stay) at other NJ hospitals

Valley Hospital · Paramus $15,248
Shore Medical Center · Somers Point $15,824
Carewell Health Medical Center · East Orange $16,877
Bayshore Medical Center · Holmdel $18,098
Southern Ocean Medical Center · Manahawkin $18,557
Deborah Heart and Lung Center · Browns Mills $19,238
Jersey Shore University Medical Center · Neptune $19,810
Jfk University Medical Center · Edison $19,869

Insurance negotiated median for the same procedure, sorted lowest first.