CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Mercy Regional Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $18,740
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.33x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Mercy Regional Medical Center is $18,740. 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 1.33x the Medicare baseline. Located in 3700 Kolbe Road, Lorain, OH.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$18,740

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: $18,740 (133%)
Ins. Median: $18,740 (133% 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
Aetna $14,251 - $31,531 101%
Blue Cross Blue Shield $14,251 - $34,608 101%
Buckeye Mycare Benefits [4237] $14,251 101%
Humana $14,251 101%
Medigold [4435] $14,251 101%
Paramount Elite [3723] $14,251 101%
UnitedHealthcare $14,251 - $33,195 101%
Devoted Health Plan [4501] $14,394 102%
Medicare (plans) $14,394 102%
Caresource Mycare Ohio [4236] $14,536 103%
Molina Mycare Ohio [4235] $14,964 106%
Buckeye [4178] $22,596 160%
Molina Marketplace Aca [4181] $22,596 160%
Caresource [4179] $25,512 181%
Medical Mutual [3067] $25,985 184%
Cigna $31,321 222%
Meritain Health [3068] $31,531 223%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3700 Kolbe Road, Lorain, OH 44053
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals