CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Reading Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $15,838
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.12x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Reading Hospital is $15,838. 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 1.12x the Medicare baseline. Located in 420 S 5Th Avenue, West Reading, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,838

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: $15,838 (112%)
Ins. Median: $15,838 (112% 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
Humana $12,700 - $15,689 90%
UnitedHealthcare $12,700 - $66,045 90%
Highmark $14,789 - $70,633 105%
Upmc $14,942 - $15,838 106%
Blue Cross Blue Shield $15,347 - $47,647 109%
Geisinger $15,375 - $38,850 109%
Amerihealth Caritas $15,390 109%
Health America $15,539 110%
Devoted Health $15,689 111%
Health Partners $15,689 111%
Pa Health & Wellness $15,689 - $25,851 111%
Senior Life $16,137 114%
Aetna $16,436 - $54,283 116%
Cigna $35,897 254%
First Health $59,711 423%
Gateway $59,711 423%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 420 S 5Th Avenue, West Reading, PA 19611
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals