CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Banner - University Medical Center Phoenix

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $21,435
Cash Discount Price: $31,544
vs. Medicare Baseline: 1.52x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Banner - University Medical Center Phoenix is $21,435. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $31,544. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.52x the Medicare baseline. Located in 1111 East McDowell Road, Phoenix, AZ.

Cash / Self-Pay

$31,544

Average discount available for prompt cash payment at this facility.

Insurance Median

$21,435

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: $31,544 (223%)

Insurance Median: $21,435 (152%)

Cash: $31,544 (223% of Medicare)

Ins. Median: $21,435 (152% 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	$19,138 - $49,722	136%
Arizona Physicians Ipa	$19,138	136%
Banner Health	$19,138	136%
Banner University Health Plan	$19,138	136%
Blue Cross Blue Shield	$19,138 - $51,179	136%
Care 1St	$19,138	136%
Gila River Health Care Corporation	$19,138	136%
Health Choice Arizona, Inc.	$19,138 - $28,708	136%
Health Net	$19,138 - $28,325	136%
Kaiser Foundation Health Plan	$19,138	136%
Mercy Care	$19,138	136%
Triwest Healthcare Alliance Corp - Va Ccn	$19,138	136%
UnitedHealthcare	$19,138 - $52,031	136%
Upmc Health Plan	$19,138	136%
Wellpoint	$19,138	136%
Humana	$19,713	140%
Carelon	$20,095	142%
Devoted Health Services	$20,095	142%
Arizona Priority Care	$21,052	149%
Gold Kidney Health Plan	$21,052	149%
Naphcare	$30,622	217%
Oscar Health Plan	$31,578	224%
Cigna	$53,446 - $59,383	379%

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 $31,544.
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 Banner - University Medical Center Phoenix 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.