CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Pinckneyville Community Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $12,748
  • Cash Discount Price: $27,246
  • vs. Medicare Baseline: 0.90x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Pinckneyville Community Hospital is $12,748. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27,246. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 0.90x the Medicare baseline. Located in 5383 State Route 154, Pinckneyville, IL.
Cash / Self-Pay
$27,246

Average discount available for prompt cash payment at this facility.

Insurance Median
$12,748

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: $27,246 (193%)
Insurance Median: $12,748 (90%)
Cash: $27,246 (193% of Medicare)
Ins. Median: $12,748 (90% 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.

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
Healthlink Hmo $2,550 18%
Healthlink Ppo - All Other Plans $2,805 20%
Healthlink Work Comp $2,805 20%
Cigna $3,657 26%
UnitedHealthcare $6,750 - $14,289 48%
Blue Cross Blue Shield $8,179 58%
Humana $12,748 90%
Umwa Mcr Adv - All Plans $12,748 90%
Wellcare Mcr Adv - All Plans $12,748 90%
Aetna $13,003 - $24,522 92%
Phcs - All Other Plans $22,342 158%
Phcs Savility $23,159 164%
Multiplan - All Plans $24,522 174%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5383 State Route 154, Pinckneyville, IL 62274
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals