CMS Price Transparency Data
Sepsis treatment (inpatient stay)
Facility: Wooster Community Hospital
Billing Code: 871 (MS-DRG)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 871
- Insurance Median: $20,647
- Cash Discount Price: $24,876
- vs. Medicare Baseline: 1.46x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Wooster Community Hospital is $20,647. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $24,876. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.46x the Medicare baseline. Located in 1761 Beall Avenue, Wooster, OH.
Cash / Self-Pay
$24,876
Average discount available for prompt cash payment at this facility.
Insurance Median
$20,647
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: $24,876 (176%)
Insurance Median: $20,647 (146%)
Cash: $24,876 (176% of Medicare)
Ins. Median: $20,647 (146% 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
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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 | $12,096 | 86% |
| Buckeye Mcaid-All Other Plans | $12,687 | 90% |
| Caresource Mcaid | $12,687 | 90% |
| UnitedHealthcare | $12,814 - $23,632 | 91% |
| Molina Mcaid | $12,941 | 92% |
| Blue Cross Blue Shield | $13,067 - $22,886 | 93% |
| Aetna | $13,321 - $22,140 | 94% |
| Amerihealth Mcaid-All Plans | $13,321 | 94% |
| Aultcare/Primecare Mcr Adv | $13,591 | 96% |
| Buckeye Mcare | $13,591 | 96% |
| Caresource Mcr Adv | $13,591 | 96% |
| Humana | $13,591 - $23,384 | 96% |
| Med Mutual Of Oh Mcr | $13,591 | 96% |
| Molina Mcr | $13,591 | 96% |
| Summacare Mcr | $13,591 | 96% |
| The Health Plan Mcr Adv | $13,591 | 96% |
| Valor Hp Mcr-All Plans | $13,591 | 96% |
| Cerco-All Plans | $17,413 | 123% |
| Magnipower-All Plans | $17,669 | 125% |
| Rayco-All Plans | $18,657 | 132% |
| Caresource Exch - All Other Plans | $19,436 | 138% |
| Christian Health Ministries-All Plans | $19,901 | 141% |
| Cigna | $19,901 | 141% |
| Health Ohio Network Employer | $19,901 | 141% |
| Wayne County-All Plans | $19,901 | 141% |
| Healthsmart Accel | $20,647 | 146% |
| Healthsmart Complete Ppo-All Other Plans | $20,647 | 146% |
| Summacare Preferred Choice | $20,647 | 146% |
| Aultcare Wayne County | $21,145 | 150% |
| Aultcare/Primetime Exch | $21,145 | 150% |
| Health Ohio Network Ppo-All Other Plans | $21,145 | 150% |
| Ohio Health Choice Supp | $21,145 | 150% |
| Ohio Health Group Hlthy - All Other Plans | $21,145 | 150% |
| Health Plan Of Upper Ohio-All Plans | $21,916 | 155% |
| The Health Plan Comm - All Other Plans | $21,916 | 155% |
| Ohio Health Group Pref | $22,140 | 157% |
| Aultcare/Primetime-All Other Plans | $22,389 | 159% |
| Healthsmart Ppo | $22,637 | 160% |
| Molina Marketplace - All Other Plans | $23,105 | 164% |
| Summacare-All Other Plans | $23,135 | 164% |
| Ohio Health Choice-All Other Plans | $23,384 | 166% |
| Healthsmart Hpo | $23,632 | 167% |
| Osu-All Plans | $23,632 | 167% |
| Central Benefits-All Plans | $23,881 | 169% |
| First Health-All Plans | $23,881 | 169% |
| Flora-All Plans | $23,881 | 169% |
| Beech Street-All Plans | $24,130 | 171% |
| Phcs-All Plans | $24,130 | 171% |
| Med Mutual Of Oh Exchange | $27,628 | 196% |
| Med Mutual Of Oh Supermed | $27,628 | 196% |
| Med Mutual Of Oh Trad-All Other Plans | $30,641 | 217% |
| Clarity Health - All Plans | $396,245 | 2807% |