CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Cleveland Clinic Avon Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $13,365
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.95x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Cleveland Clinic Avon Hospital is $13,365. 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 0.95x the Medicare baseline. Located in 33300 Cleveland Clinic Blvd, Avon, OH.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$13,365

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: $13,365 (95%)
Ins. Median: $13,365 (95% 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
Blue Cross Blue Shield $11,984 - $15,175 85%
Aetna $12,976 - $26,330 92%
Devoted Health $12,976 92%
Humana $12,976 92%
Mmo $12,976 - $27,171 92%
Summacare $12,976 92%
The Health Plan $12,976 92%
United $12,976 - $30,389 92%
UnitedHealthcare $12,976 92%
Upmc $12,976 92%
Valor $12,976 92%
Cigna $13,365 - $30,413 95%
Communicare $13,624 97%
Perennial Health $14,014 99%
Pphp $14,273 101%
Zing Health $14,273 101%
Medical Benefit Corp $49,800 353%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 33300 Cleveland Clinic Blvd, Avon, OH 44011
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals