CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Mercy Hospital Ozark

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $1,976
Cash Discount Price: $13,344
vs. Medicare Baseline: 0.14x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Mercy Hospital Ozark is $1,976. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13,344. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 0.14x the Medicare baseline. Located in 801 West River Street, Ozark, AR.

Cash / Self-Pay

$13,344

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,976

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%)

Cash / Self-Pay: $13,344 (95%)

Insurance Median: $1,976 (14%)

Cash: $13,344 (95% of Medicare)

Ins. Median: $1,976 (14% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$1,976	14%
American Health Advantage Of Mo Mcr [20264]	$1,976	14%
Blue Cross Blue Shield	$1,976 - $3,892	14%
Cherokee Nation Health Serv Contracted [320066]	$1,976	14%
Cross Timbers Hospice [20098]	$1,976	14%
Dept Of Veteran Affairs Contracted [320106]	$1,976	14%
Elara Caring Aspire Hospice Contracted [320433]	$1,976	14%
Elara Caring Aspire Hospice [20433]	$1,976	14%
Globalhealth Contracted [320145]	$1,976	14%
Halo Hcr Inc Hospice Contracted [320432]	$1,976	14%
Halo Hcr Inc Hospice [20432]	$1,976	14%
Humana	$1,976	14%
Independent Health [20197]	$1,976	14%
Indian Health Service Contracted [320198]	$1,976	14%
Indian Health Service [20198]	$1,976	14%
Jordan Valley Senior Care Pace [20515]	$1,976	14%
Kindful Hospice Contracted [320434]	$1,976	14%
Kindful Hospice [20434]	$1,976	14%
Medical Associates Health [20444]	$1,976	14%
Medicare (plans)	$1,976 - $2,075	14%
Mercy Hospice Okc [20252]	$1,976	14%
Pace Of The Ozarks [20518]	$1,976	14%
Provider Partners Health Plans Contracted [320450]	$1,976	14%
Qual Choice Contracted [320325]	$1,976	14%
Spina Bifida Hlthcare Benefit [20506]	$1,976	14%
UnitedHealthcare	$1,976 - $5,061	14%
Valir Pace [20503]	$1,976	14%
Wellfirst Health Mcr [20443]	$1,976	14%
Cigna	$2,075	15%
Ambetter / Centene	$3,766	27%
Home State Health Plan Contracted [320187]	$3,766	27%
Medicaid / KanCare	$3,766 - $7,958	27%
Novasys Contracted [320285]	$3,766 - $13,131	27%
Usable Contracted [320409]	$3,892	28%
United Medical Resources Contracted [320454]	$5,061	36%
Health Choice Contracted [320166]	$25,117	178%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $13,344.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 871.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercy Hospital Ozark is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 871.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.