CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Memorial Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $19,682
Cash Discount Price: $30,713
vs. Medicare Baseline: 1.39x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Memorial Hospital is $19,682. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30,713. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.39x the Medicare baseline. Located in 4500 Memorial Drive, Belleville, IL.

Cash / Self-Pay

$30,713

Average discount available for prompt cash payment at this facility.

Insurance Median

$19,682

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: $30,713 (218%)

Insurance Median: $19,682 (139%)

Cash: $30,713 (218% of Medicare)

Ins. Median: $19,682 (139% 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
Healthscope Benefits [258]	$6,564	46%
UnitedHealthcare	$6,564 - $13,674	46%
Aetna	$13,674	97%
Blue Cross Blue Shield	$13,674 - $31,221	97%
Essence Healthcare [221]	$13,674	97%
Humana	$13,674	97%
Cox Health [757]	$14,358	102%
Devoted Health Plan [847]	$14,358	102%
Medica [662]	$14,358	102%
Cigna	$19,682 - $30,008	139%
Health Alliance [224]	$21,605	153%
Consociate [478]	$22,951 - $26,395	163%
Sarah Bush Lincoln [636]	$26,395	187%
Apwu Health Plan [216]	$30,008	213%
Nalc Health Benefit Plan [242]	$30,008	213%
Priority Health [648]	$30,008	213%

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 $30,713.
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 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.