CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Saint Thomas Highlands Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $14,597
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Saint Thomas Highlands Hospital is $14,597. 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 1.03x the Medicare baseline. Located in 401 Sewell Dr, Sparta, TN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$14,597

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: $14,597 (103%)
Ins. Median: $14,597 (103% 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
Blue Cross Blue Shield $3,131 - $18,292 22%
Amerigroup Mcaid Replacement $6,753 - $8,565 48%
Oscar Health $8,394 - $9,510 59%
Community Plan $9,156 65%
Cigna $9,564 - $28,188 68%
Smart Health $10,900 - $20,436 77%
UnitedHealthcare $11,485 - $15,974 81%
Point Comfort Underwriters $13,137 93%
Amerigroup Mcr Replacement $14,597 103%
Ascension Complete $14,597 103%
Centurion Of Tn $14,597 103%
Covid Uninsured Test Fund $14,597 103%
Healthspring Mcr Replacement $14,597 103%
Humana $14,597 103%
Medicare (plans) $14,597 103%
Nhc Advantage $14,597 103%
Aetna $14,889 - $20,300 105%
Ambetter / Centene $18,976 134%
Health 2 Business $23,810 - $27,375 169%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 401 Sewell Dr, Sparta, TN 38583
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals