CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Rush University Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $25,670
Cash Discount Price: $43,593
vs. Medicare Baseline: 1.82x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Rush University Medical Center is $25,670. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43,593. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.82x the Medicare baseline. Located in 1653 West Congress Parkway, Chicago, IL.

Cash / Self-Pay

$43,593

Average discount available for prompt cash payment at this facility.

Insurance Median

$25,670

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: $43,593 (309%)

Insurance Median: $25,670 (182%)

Cash: $43,593 (309% of Medicare)

Ins. Median: $25,670 (182% 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
UnitedHealthcare	$3,038 - $31,272	22%
Cigna	$20,153 - $44,465	143%
Aetna	$23,164 - $38,125	164%
Blue Cross Blue Shield	$23,164 - $38,265	164%
Devoted Mcr Adv - All Plans	$23,164	164%
Humana	$23,164	164%
Wellcare Mcr Adv - All Plans	$23,164	164%
Molina Fide-Snp	$24,091	171%
Meridian Dnsp	$24,323	172%
Zing Hlth Mcr Adv - All Plans	$24,554	174%
Ambetter / Centene	$31,272	222%
Molina Exch - All Other Plans	$31,504	223%

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 $43,593.
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 Rush University 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.