CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Allegheny General Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $15,134
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Allegheny General Hospital is $15,134. 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 1.07x the Medicare baseline. Located in 320 East North Avenue, Pittsburgh, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,134

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: $15,134 (107%)
Ins. Median: $15,134 (107% 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
Geisinger $2,734 - $14,992 19%
Highmark $10,506 - $38,711 74%
Life Pittsburgh $14,278 101%
The Health Plan Of The Upper Ohio Valley $14,278 - $15,706 101%
UnitedHealthcare $14,278 - $15,420 101%
Aetna $14,849 - $38,987 105%
Martin'S Point $14,971 106%
Amerihealth $14,992 106%
Highmark Wholecare $15,134 107%
Humana $15,134 107%
Medicare (plans) $15,134 - $16,562 107%
Cigna $15,277 - $40,912 108%
Jefferson Health Plans $15,420 109%
Molina $15,563 110%
American Health Plans $15,706 111%
Medical Mutual $40,912 290%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 320 East North Avenue, Pittsburgh, PA 15212
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals