CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Kettering Health Miamisburg

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $16,470
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Kettering Health Miamisburg is $16,470. 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 1.17x the Medicare baseline. Located in 4000 Miamisburg-Centerville Road, Miamisburg, OH.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$16,470

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: $16,470 (117%)
Ins. Median: $16,470 (117% 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 $15,685 - $34,192 111%
Blue Cross Blue Shield $15,685 - $36,348 111%
Buckeye Health Plan $15,685 - $26,665 111%
Caresource $15,685 - $24,242 111%
Cigna $15,685 - $39,792 111%
Devoted Health $15,685 111%
Humana $15,685 111%
Medical Mutual $15,685 - $40,898 111%
Medigold $15,685 111%
The Health Plan $15,685 111%
UnitedHealthcare $15,685 - $41,289 111%
Valor Health Plan $15,685 111%
Molina Healthcare $16,470 - $34,281 117%
Perennial Advantage $16,470 117%
Custom Design Benefits Inc. $36,859 261%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4000 Miamisburg-Centerville Road, Miamisburg, OH 45342
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals