CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Piedmont Augusta Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $21,664
Cash Discount Price: $17,359
vs. Medicare Baseline: 1.53x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Piedmont Augusta Hospital is $21,664. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17,359. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.53x the Medicare baseline. Located in 1350 Walton Way, Augusta, GA.

Cash / Self-Pay

$17,359

Average discount available for prompt cash payment at this facility.

Insurance Median

$21,664

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: $17,359 (123%)

Insurance Median: $21,664 (153%)

Cash: $17,359 (123% of Medicare)

Ins. Median: $21,664 (153% 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
Medicare (plans)	$13,876 - $14,415	98%
Blue Cross Blue Shield	$14,036 - $46,006	99%
UnitedHealthcare	$14,078 - $38,687	100%
Clear Spring Health Care [30192]	$14,280	101%
Georgia Health Advantage [30143]	$14,549	103%
Ambetter / Centene	$24,140	171%
Aetna	$28,891	205%
Caresource Marketplace [11106]	$29,016	206%
First Health [10303]	$41,162	292%
Cigna	$43,838	311%

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 $17,359.
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 Piedmont Augusta Hospital 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.