CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Hospital of Univ of Pennsylvania

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $21,514
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.52x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Hospital of Univ of Pennsylvania is $21,514. 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 1.52x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$21,514

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: $21,514 (152%)
Ins. Median: $21,514 (152% 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
Paired Kidney Exchange $1,683 12%
UnitedHealthcare $3,308 - $42,751 23%
Workers Compensation $3,833 27%
Kaiser Permanente $4,084 - $16,469 29%
Interlink $4,368 31%
Blue Quality Centers For Transplant (Bqct) $4,387 31%
Cigna $4,910 - $40,948 35%
Penn Life (Living Independently For Elders) $16,121 114%
Blue Cross Blue Shield $16,469 - $84,770 117%
Medicare (plans) $16,469 - $21,514 117%
Upmc $16,469 117%
Ibc $16,896 120%
Geisinger Health Plan $16,963 - $58,556 120%
Health Partners $16,963 120%
Humana $16,963 120%
Devoted Health $17,293 122%
Keystone First $17,293 122%
Pa Health And Wellness $17,293 - $35,498 122%
Aetna $17,457 - $40,726 124%
Clover Health Plan $17,457 124%
Gateway Health Plan $17,954 127%
Philadelphia Va Medical Center $21,514 152%
Us Family Health Plan $22,011 156%
Ibc Commercial Hpn $25,138 178%
Elap $30,550 216%
Keystone Hmo Proactive $34,355 243%
Claims Watcher $34,422 - $38,725 244%
Oscar Health Plan $36,574 259%
Centivo $38,725 274%
Elap Services $40,016 283%
Pgm - Embassy Of Qatar $40,877 290%
Olympus $41,173 292%
Pgm - Embassy Of The United Emirates/Ipc $44,022 312%
Qualcare $44,886 318%
Highmark $48,770 345%
Penn Global Medicine $57,012 404%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals