CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Cass County Memorial Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $16,992
Cash Discount Price: $7,866
vs. Medicare Baseline: 1.20x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Cass County Memorial Hospital is $16,992. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,866. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.20x the Medicare baseline. Located in 1501 East Tenth Street, Atlantic, IA.

Cash / Self-Pay

$7,866

Average discount available for prompt cash payment at this facility.

Insurance Median

$16,992

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: $7,866 (56%)

Insurance Median: $16,992 (120%)

Cash: $7,866 (56% of Medicare)

Ins. Median: $16,992 (120% 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
Midlands Choice Medica Mcr	$2,247	16%
Wellmark Hmo	$6,630	47%
Wellmark Ppo - All Other Plans	$6,630	47%
Midlands Choice New Bus	$7,304	52%
Medica Comm - All Other Plans	$9,889	70%
UnitedHealthcare	$10,203 - $16,992	72%
Midlands Choice Pho (Ppo) - All Other Plans	$10,338	73%
Aetna	$10,675 - $28,229	76%
Multiplan - All Plans	$10,675	76%
Molina Mcaid - All Plans	$11,237	80%
Amerigroup Mcr Adv - All Other Plans	$16,992	120%
Medica Mcr Adv	$16,992	120%
Va Ccn - All Plans	$16,992	120%
Medicaid / KanCare	$23,607	167%
Iowa Total Care Mcaid	$24,079	171%
Triwest - All Plans	$27,719	196%
Iowa Total Care Comm - All Other Plans	$27,957	198%
Tricare	$28,229	200%
Wellmark Mcr Adv	$28,399	201%
Iowa Total Care Mcr	$28,569	202%
American Hlth Mcr Adv - All Plans	$28,739	204%

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 $7,866.
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 Cass County Memorial 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.