CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Southern Coos Hospital & Health Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $41,649
Cash Discount Price: $46,535
vs. Medicare Baseline: 2.95x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Southern Coos Hospital & Health Center is $41,649. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46,535. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 2.95x the Medicare baseline. Located in 900 11Th Street Se, Bandon, OR.

Cash / Self-Pay

$46,535

Average discount available for prompt cash payment at this facility.

Insurance Median

$41,649

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: $46,535 (330%)

Insurance Median: $41,649 (295%)

Cash: $46,535 (330% of Medicare)

Ins. Median: $41,649 (295% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 295% of the Medicare baseline (a markup of 195%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Tricare	$17,292	122%
Aetna	$19,650 - $41,881	139%
Atrio Mcr Adv - Allplans	$19,650	139%
Confederated Tribes - All Plans	$19,650	139%
Moda Mcr Adv	$19,650	139%
Pacific Source Mcr Adv	$19,650	139%
Advanced Health - All Plans	$29,317	208%
Cigna	$36,763	260%
Healthnet - All Plans	$38,624	274%
Moda Health Plan - All Other Plans	$41,416	293%
Prov Netwrk Of America - All Plans	$41,881	297%
Three Rivers - All Plans	$41,881	297%
UnitedHealthcare	$41,881	297%
First Choice - All Plans	$42,812	303%
Blue Cross Blue Shield	$43,278	307%
Multiplan - All Plans	$43,278	307%
First Health - All Plans	$44,208	313%
Pacific Source - All Other Plans	$44,208	313%
Providence Preferred - All Plans	$44,208	313%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $46,535.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 871.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Southern Coos Hospital & Health Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 871.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.