CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Warner Hospital and Health Services

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $20,282
Cash Discount Price: $40,378
vs. Medicare Baseline: 1.44x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Warner Hospital and Health Services is $20,282. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40,378. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.44x the Medicare baseline. Located in 422 W White St, Clinton, IL.

Cash / Self-Pay

$40,378

Average discount available for prompt cash payment at this facility.

Insurance Median

$20,282

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: $40,378 (286%)

Insurance Median: $20,282 (144%)

Cash: $40,378 (286% of Medicare)

Ins. Median: $20,282 (144% 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
Humana	$3,300 - $19,691	23%
UnitedHealthcare	$3,600 - $19,691	26%
Aetna	$5,481 - $19,691	39%
Blue Cross Blue Shield	$19,691 - $39,571	139%
Health Alliance Med Adv	$19,691	139%
Molina Mcr/Mcd Dual	$19,691	139%
Wellcare Mcr Adv-All Plans	$19,691	139%
Healthlink Hmo	$31,495	223%
City Of Clinton (Employees Serv)-All Plans	$32,302	229%
Cigna	$33,514	237%
Caterpillar-All Plans	$34,321	243%
Health Alliance-All Other Plans	$34,321	243%
Multiplan Phcs-All Plans	$34,321	243%
Healthlink Ppo/Work Comp-All Other Plans	$35,533	252%
Consociate Care Ppo-All Plans	$36,340	257%
Hfn Ppo/Epo-All Plans	$36,340	257%
Three Rivers-All Plans	$38,359	272%

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 $40,378.
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 Warner Hospital and Health Services 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.