CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Mercy Hospital Ardmore, Inc

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $14,680
  • Cash Discount Price: $25,954
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Mercy Hospital Ardmore, Inc is $14,680. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25,954. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.04x the Medicare baseline. Located in 1011 14Th Ave Nw, Ardmore, OK.
Cash / Self-Pay
$25,954

Average discount available for prompt cash payment at this facility.

Insurance Median
$14,680

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: $25,954 (184%)
Insurance Median: $14,680 (104%)
Cash: $25,954 (184% of Medicare)
Ins. Median: $14,680 (104% 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
Cigna $3,242 - $15,129 23%
United Medical Resources Contracted [320454] $4,068 29%
UnitedHealthcare $4,068 - $14,964 29%
Aetna $8,111 - $14,680 57%
Humana $8,111 - $18,145 57%
Medicaid / KanCare $8,111 - $19,454 57%
Preferred Community Choice Contracted [320311] $11,620 82%
Community Care Contracted [320080] $11,621 - $22,447 82%
Workers Comp [20426] $12,214 87%
Blue Cross Blue Shield $14,680 - $47,678 104%
Cherokee Nation Health Serv Contracted [320066] $14,680 104%
Cross Timbers Hospice [20098] $14,680 104%
Dept Of Veteran Affairs Contracted [320106] $14,680 104%
Elara Caring Aspire Hospice Contracted [320433] $14,680 104%
Elara Caring Aspire Hospice [20433] $14,680 104%
Halo Hcr Inc Hospice Contracted [320432] $14,680 104%
Halo Hcr Inc Hospice [20432] $14,680 104%
Independent Health [20197] $14,680 104%
Indian Health Service Contracted [320198] $14,680 104%
Kindful Hospice Contracted [320434] $14,680 104%
Kindful Hospice [20434] $14,680 104%
Medical Associates Health [20444] $14,680 104%
Medicare (plans) $14,680 - $15,563 104%
Mercy Hospice Okc [20252] $14,680 104%
Provider Partners Health Plans Contracted [320450] $14,680 104%
Qual Choice Contracted [320325] $14,680 104%
Tribute Health Plan Mcr Contracted [320338] $14,680 104%
Tricare $14,680 104%
Globalhealth Contracted [320145] $14,979 106%
Osma Health Contracted [320292] $15,322 109%
Healthsmart Accel Contracted [320183] $18,190 129%
Healthsmart Preferred Care Contracted [320184] $18,963 - $33,031 134%
Ambetter / Centene $19,454 138%
Home State Health Plan Contracted [320187] $19,454 138%
Novasys Contracted [320285] $19,454 138%
Medica Contracted [320239] $19,920 141%
Globalhealth Contracted [320144] $20,445 145%
Health Choice Contracted [320166] $25,117 178%
Kempton Contracted [320214] $33,031 234%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1011 14Th Ave Nw, Ardmore, OK 73401
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals