CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Providence Holy Family Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $26,861
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.90x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Providence Holy Family Hospital is $26,861. 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 1.90x the Medicare baseline. Located in 5633 North Lidgerwood, Spokane, WA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$26,861

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: $26,861 (190%)
Ins. Median: $26,861 (190% 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 $3,725 - $30,219 26%
Kaiser $16,788 119%
Molina $16,788 - $18,131 119%
Providence Health Plan $17,460 - $31,827 124%
UnitedHealthcare $17,964 - $46,104 127%
Blue Shield $18,131 - $44,664 128%
Amerigroup $18,467 131%
Community Health Plan Of Washington $18,467 131%
Humana $18,467 131%
Community Health Plan $26,861 190%
Coordinated Care $26,861 - $31,059 190%
First Choice $38,721 274%
Cigna $39,540 280%
Aetna $41,189 292%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5633 North Lidgerwood, Spokane, WA 99208
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals