CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Aurora Medical Ctr Oshkosh

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $39,379
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.79x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Aurora Medical Ctr Oshkosh is $39,379. 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 2.79x the Medicare baseline. Located in 855 N Westhaven Drive, Oshkosh, WI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$39,379

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: $39,379 (279%)
Ins. Median: $39,379 (279% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 279% of the Medicare baseline (a markup of 179%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $29,506 209%
Healthpartners $32,265 - $36,950 229%
Everpointe Elite $34,007 241%
Aurora Caregiver $34,974 248%
Common Ground $36,095 256%
Quartz One $36,103 256%
Blue Cross Blue Shield $36,144 - $47,593 256%
Health Payment Systems $36,299 257%
Molina Exchange $37,884 268%
Wisconsin Physician Service $39,379 - $41,451 279%
UnitedHealthcare $39,554 - $44,436 280%
Trilogy $40,168 285%
Hs Technology $40,304 286%
Centivo $40,737 289%
Quartz Group $42,244 299%
Cigna $43,166 306%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 855 N Westhaven Drive, Oshkosh, WI 54904
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals