Sepsis treatment (inpatient stay)
Facility: St Charles Medical Center Prineville
Billing Code: 871 (MS-DRG)
- CPT Billing Code: 871
- Insurance Median: $5,493
- Cash Discount Price: $24,153
- vs. Medicare Baseline: 0.39x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
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 | $5,349 | 38% |
| Ageright Advantage [142] | $5,349 | 38% |
| Champ Va [700] | $5,349 | 38% |
| Cigna | $5,349 | 38% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $5,349 | 38% |
| Devoted Health Inc [145] | $5,349 | 38% |
| Health Market Care Assured [134] | $5,349 | 38% |
| Health Net Med Adv [135] | $5,349 | 38% |
| Humana | $5,349 | 38% |
| Indian Health [704] | $5,349 | 38% |
| Kaiser Permanente Med Adv [136] | $5,349 | 38% |
| Law Enforcement [701] | $5,349 | 38% |
| Medicare (plans) | $5,349 - $6,205 | 38% |
| Samaritan Health Plan Med Adv [141] | $5,349 | 38% |
| Unicare [133] | $5,349 | 38% |
| UnitedHealthcare | $5,349 | 38% |
| Veterans [706] | $5,349 | 38% |
| Wellcare [132] | $5,349 | 38% |
| Blue Cross Blue Shield | $5,884 - $42,279 | 42% |
| Pacificsource Community Solutions [525] | $12,869 - $14,264 | 91% |
| Otj Dept Of Labor Federal Emp [652] | $16,888 | 120% |
| Otj Us Department Of Labor [669] | $16,888 | 120% |
| Kaiser Permanente [334] | $31,243 | 221% |
| Moda [310] | $33,776 | 239% |
| Providence Health Plan [347] | $33,776 | 239% |
| Bridgespan [342] | $35,937 | 255% |
| Rx Internal [4100003] | $41,769 | 296% |
| Asuris Northwest Health [202] | $42,279 | 299% |
| Healthcare Management Admin [201] | $42,279 | 299% |
| Regence Group Administrators [203] | $42,279 | 299% |