CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Legacy Good Samaritan Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $21,579
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.53x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Legacy Good Samaritan Medical Center is $21,579. 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 1.53x the Medicare baseline. Located in 1015 Nw 22Nd Avenue, W121, Portland, OR.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$21,579

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: $21,579 (153%)
Ins. Median: $21,579 (153% 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
Kaiser $19,440 - $38,881 138%
Atrio $20,024 142%
UnitedHealthcare $20,024 - $43,549 142%
Aetna $20,412 - $53,419 145%
Blue Cross Blue Shield $20,412 - $41,326 145%
Devoted Health $20,412 145%
Humana $20,412 145%
Healthnet $20,607 146%
Careoregon $20,996 149%
Pacificsource $20,996 - $37,082 149%
Ageright $21,385 151%
Cigna $21,385 151%
Providence $21,385 151%
Samaritan Health Services $21,385 151%
Moda $21,773 - $48,616 154%
Summit Health $21,773 154%
Health 2 Business $35,321 250%
Providence Health Plan $38,881 275%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1015 Nw 22Nd Avenue, W121, Portland, OR 97210
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals