CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Phoenixville Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $15,338
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.09x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Phoenixville Hospital is $15,338. 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 1.09x the Medicare baseline. Located in 140 Nutt Road, Phoenixville, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,338

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: $15,338 (109%)
Ins. Median: $15,338 (109% 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
UnitedHealthcare $12,416 - $23,310 88%
Humana $14,329 - $15,338 102%
Pa Health And Wellness $14,602 - $14,900 103%
Blue Cross Blue Shield $14,607 - $39,019 103%
Health America $14,607 103%
Highmark $14,607 - $35,936 103%
Keystone First $14,607 103%
Gateway $15,031 106%
Geisinger $15,031 - $23,310 106%
Cigna $15,192 - $27,725 108%
Devoted Health $15,192 108%
Health Partners $15,338 109%
Provider Partners $15,338 109%
Upmc $15,338 109%
Vibra $15,338 109%
Sunrise $15,747 112%
Aetna $15,776 - $26,224 112%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 140 Nutt Road, Phoenixville, PA 19460
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals