CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Kaleida Health

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $22,584
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.60x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Kaleida Health is $22,584. 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 1.60x the Medicare baseline. Located in 100 High Street, Buffalo, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$22,584

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: $22,584 (160%)
Ins. Median: $22,584 (160% 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
Tricare $21,455 152%
Independent Health Association $21,816 - $22,584 155%
Independent Health Association - Wchob $21,816 155%
Univera $22,133 157%
Univera - Wchob $22,133 157%
Blue Cross Blue Shield $22,584 160%
Cigna $22,584 160%
Fallon Health $22,584 160%
Kalos Health $22,584 160%
UnitedHealthcare $22,584 - $23,036 160%
Vns $22,584 160%
Wellcare $22,584 160%
Fidelis $23,713 168%
Aetna $23,939 - $42,372 170%
Centers Plan For Healthy Living $23,939 170%
Upmc $24,391 173%
Magnacare $26,899 191%
Ghi/Emblem Health $28,269 200%
Ghi/Emblem Health - Wchob $29,097 206%
Magnacare - Wchob $35,551 252%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 High Street, Buffalo, NY 14210
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals