CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: PAM Specialty Hospital of Wilkes-Barre

Billing Code: 871 (MS-DRG)

The BaseRate · fair price medium confidence

A fair price for this

$28,652

about 2.0× the $14,117 Medicare rate · typically $11,649–$51,629

modeled estimate · not a bill or quote

What this hospital charges insurers

$39,614

Above the fair price

about $10,962 over the fair price · 2.8× Medicare

Medicare pays $14,117 Fair price $28,652 This hospital $39,614

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

Highest price of the 9 PA hospitals we have prices for — worth calling around.

Cheapest $12,085 Priciest $39,614

Black dot = this hospital, among the 9 PA hospitals with a price for this procedure. Full list below.

A fair price for a Sepsis treatment (inpatient stay) is about $28,652 (about 2.0× the $14,117 Medicare rate). PAM Specialty Hospital of Wilkes-Barre charges insurers about $39,614 — above the fair price. Located in Wilkes-Barre, PA.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $28,652. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

2 of 6 major insurers have a published price at this hospital

✓ Blue Cross Blue Shield✓ Aetna UnitedHealthcareCignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
Blue Cross Blue Shieldmajor	$36,544	259%
Aetnamajor	$39,614	281%
Ambetter (Centene)	$39,614	281%
AmeriHealth	$39,614	281%
Geisinger	$40,406	286%
+ 3 smaller / regional plans	$39,614

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 871.

Insurance Before you use insurance

Call your insurance company to confirm PAM Specialty Hospital of Wilkes-Barre is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 871.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at PAM Specialty Hospital of Wilkes-Barre

Compare: Sepsis treatment (inpatient stay) at other PA hospitals

Geisinger-Bloomsburg Hospital · Bloomsburg $12,085
Chan Soon- Shiong Medical Center at Windber · Windber $13,314
Penn State Health Lancaster Medical Center · Lancaster $13,631
Advanced Surgical Hospital · Washington $14,182
Meadville Medical Center · Meadville $14,284
Allegheny Valley Hospital · Natrona $14,326
Canonsburg General Hospital · Canonsburg $14,337
Punxsutawney Area Hospital · Punxsutawney $14,586

Insurance negotiated median for the same procedure, sorted lowest first.