CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Banner-University Medical Center South Campus

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $20,548
Cash Discount Price: $22,739
vs. Medicare Baseline: 1.46x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Banner-University Medical Center South Campus is $20,548. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $22,739. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.46x the Medicare baseline. Located in 2800 East Ajo Way, Tucson, AZ.

Cash / Self-Pay

$22,739

Average discount available for prompt cash payment at this facility.

Insurance Median

$20,548

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: $22,739 (161%)

Insurance Median: $20,548 (146%)

Cash: $22,739 (161% of Medicare)

Ins. Median: $20,548 (146% 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	$18,680 - $49,722	132%
Arizona Physicians Ipa	$18,680	132%
Banner Health	$18,680	132%
Banner University Health Plan	$18,680	132%
Blue Cross Blue Shield	$18,680 - $25,683	132%
Care 1St	$18,680	132%
Gila River Health Care Corporation	$18,680	132%
Health Choice Arizona, Inc.	$18,680 - $28,020	132%
Health Net	$18,680 - $27,647	132%
Kaiser Foundation Health Plan	$18,680	132%
Mercy Care	$18,680	132%
Triwest Healthcare Alliance Corp - Va Ccn	$18,680	132%
UnitedHealthcare	$18,680 - $34,319	132%
Upmc Health Plan	$18,680	132%
Wellpoint	$18,680	132%
Humana	$19,241	136%
Carelon	$19,614	139%
Devoted Health Services	$19,614	139%
Arizona Priority Care	$20,548	146%
Gold Kidney Health Plan	$20,548	146%
Naphcare	$29,888	212%
Oscar Health Plan	$30,822	218%
Cigna	$35,885	254%

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 $22,739.
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 South Campus 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.