CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: UW Health

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $13,823
Cash Discount Price: $16,147
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at UW Health is $13,823. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16,147. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 0.98x the Medicare baseline. Located in 1401 East State Street, Rockford, IL.

Cash / Self-Pay

$16,147

Average discount available for prompt cash payment at this facility.

Insurance Median

$13,823

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: $16,147 (114%)

Insurance Median: $13,823 (98%)

Cash: $16,147 (114% of Medicare)

Ins. Median: $13,823 (98% 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
Aetna	$13,822 - $21,544	98%
Blue Cross Blue Shield	$13,822 - $24,549	98%
Humana	$13,822	98%
Medicare (plans)	$13,822 - $15,205	98%
Mychoice Wi Medical Adv	$13,822	98%
UnitedHealthcare	$13,822 - $30,179	98%
Quartz Fully Insured	$16,261	115%
Quartz Aso	$17,488	124%
Cigna	$23,698	168%
Alliance Premier Network	$26,270	186%
The Alliance	$39,070	277%

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 $16,147.
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 UW Health 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.