CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: John Randolph Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $15,208
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.08x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at John Randolph Medical Center is $15,208. 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 1.08x the Medicare baseline. Located in 411 West Randolph Road, Hopewell, VA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,208

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: $15,208 (108%)
Ins. Median: $15,208 (108% 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
United $4,267 - $14,765 30%
Humana $14,765 105%
Sentara Health $14,765 105%
United Behavioral Health $14,765 105%
Cigna $15,061 - $30,600 107%
Devoted $15,061 107%
Virginia Premier Health $15,061 107%
Aetna $15,081 - $19,905 107%
Align Senior Care $15,208 108%
Blue Cross Blue Shield $15,208 - $45,047 108%
Clear Spring Health Plan $15,208 108%
Naphcare $15,208 108%
Davita Village Health $15,356 109%
Lifeworks $15,504 110%
Pyramid Life $16,242 115%
Universal Healthcare Group $16,242 115%
Optima Health $20,738 147%
Oscar $22,451 159%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 411 West Randolph Road, Hopewell, VA 23860
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals