CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Holy Family Memorial

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $27,044
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.92x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Holy Family Memorial is $27,044. 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 1.92x the Medicare baseline. Located in 2300 Western Ave, Manitowoc, WI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$27,044

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: $27,044 (192%)
Ins. Median: $27,044 (192% 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 $13,596 - $34,196 96%
Community Care Incorporated $13,596 96%
Health Partners $13,596 - $39,576 96%
Humana $13,596 96%
Icare $13,596 96%
Molina $13,596 - $14,684 96%
Network Health Plan $13,596 - $36,422 96%
Security Health Plan $13,596 96%
UnitedHealthcare $13,596 - $57,234 96%
Allwell $13,868 98%
Health Payment Systems $25,085 178%
Chorus Community Health Plan $26,715 189%
Wps Health Plan $27,373 194%
Dean Health Plan $33,807 239%
Centivo $36,210 - $43,823 257%
Medical College Of Wisconsin $39,137 277%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2300 Western Ave, Manitowoc, WI 54221
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals