CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Forbes Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $14,881
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Forbes Hospital is $14,881. 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 1.05x the Medicare baseline. Located in 2570 Haymaker Road, Monroeville, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$14,881

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: $14,881 (105%)
Ins. Median: $14,881 (105% 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 - $14,603 19%
Highmark $8,221 - $28,924 58%
Life Pittsburgh $13,908 99%
The Health Plan Of The Upper Ohio Valley $13,908 - $15,298 99%
UnitedHealthcare $13,908 - $15,020 99%
Aetna $14,464 - $33,198 102%
Amerihealth $14,603 103%
Highmark Wholecare $14,742 104%
Humana $14,742 104%
Medicare (plans) $14,742 - $16,133 104%
Cigna $14,881 - $32,558 105%
Martin'S Point $14,971 106%
Jefferson Health Plans $15,020 106%
Molina $15,159 107%
American Health Plans $15,298 108%
University Of Pittsburgh Medical Center $15,716 111%
Medical Mutual $32,558 231%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2570 Haymaker Road, Monroeville, PA 15146
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals