CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Connecticut Childrens Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $8,373
Cash Discount Price: $39,299
vs. Medicare Baseline: 0.59x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Connecticut Childrens Medical Center is $8,373. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39,299. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 0.59x the Medicare baseline. Located in 282 Washington Street, Hartford, CT.

Cash / Self-Pay

$39,299

Average discount available for prompt cash payment at this facility.

Insurance Median

$8,373

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: $39,299 (278%)

Insurance Median: $8,373 (59%)

Cash: $39,299 (278% of Medicare)

Ins. Median: $8,373 (59% 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
Harvard Pilgrim [1001134]	$6,679 - $9,226	47%
Multiplan [1001126]	$6,679	47%
UnitedHealthcare	$6,679 - $10,319	47%
Aetna	$7,536 - $8,373	53%
Cigna	$8,345	59%
Great West Healthcare [100107]	$8,345	59%
Mvp Health Plan [100144]	$8,345	59%
1199 National Benefit Fund [100134]	$8,373	59%
Government Employees Hospital Assoc [100115]	$8,373	59%
Humana	$8,373	59%
Meritain Health [100149]	$8,373	59%
Nippon Life Ins Co Of America [100112]	$8,373	59%
Yale Health Plan [100162]	$8,373	59%
Blue Cross Blue Shield	$8,541	61%
Unicare [100148]	$8,541	61%
Wellpoint [100150]	$8,541	61%
Golden Rule [100106]	$9,226	65%
Oxford [100103]	$9,226	65%
Connecticare [100105]	$9,375 - $10,319	66%
Emblem Health Commercial [1001108]	$10,319	73%

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 $39,299.
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 Connecticut Childrens Medical Center 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.