CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: San Juan Regional Medical Center Inc

Billing Code: 871 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$17,241

about 1.2× the $14,117 Medicare rate · typically $14,939–$22,274

modeled estimate · not a bill or quote

Medicare pays $14,117 Fair price $17,241 Cash price $31,527 Hospital's list price $63,054

How we calculate the fair BaseRate →

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✓ Aetna✓ Cigna✓ Humana Blue Cross Blue ShieldKaiser 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	$15,278 - $48,047	108%
Aetnamajor	$56,749	402%
Cignamajor	$49,107	348%
Humanamajor	$16,017 - $50,443	113%
Health Net	$50,443	357%
Presbyterian	$15,289 - $20,319	108%
+ 7 smaller / regional plans	$11,550 - $50,443

Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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 31,527), 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 San Juan Regional Medical Center Inc 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 San Juan Regional Medical Center Inc

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

Alta Vista Regional Hospital · Las Vegas $13,161
Christus St Vincent Regional Medical Center · Santa Fe $13,768
Gila Regional Medical Center · Silver City $14,082
Holy Cross Hospital A Div of Taos Health Systems · Taos $14,851
Carlsbad Medical Center · Carlsbad $15,306
Mountain View Regional Medical Center · Las Cruces $15,435
Eastern New Mexico Medical Center · Roswell $15,753
Covenant Health Hobbs Hospital · Hobbs $18,093

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