CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Hammond Henry Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $12,586
Cash Discount Price: $30,289
vs. Medicare Baseline: 0.89x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Hammond Henry Hospital is $12,586. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30,289. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 0.89x the Medicare baseline. Located in 600 N College Avenue, Geneseo, IL.

Cash / Self-Pay

$30,289

Average discount available for prompt cash payment at this facility.

Insurance Median

$12,586

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: $30,289 (215%)

Insurance Median: $12,586 (89%)

Cash: $30,289 (215% of Medicare)

Ins. Median: $12,586 (89% 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	$2,400 - $12,586	17%
Multiplan Phcs Pediatric	$2,400	17%
Healthsmart Adult-All Other Plans	$3,880	27%
Blue Cross Blue Shield	$4,396 - $4,943	31%
Healthsmart Pediatric	$4,400	31%
Multiplan Phcs Adult	$4,400	31%
Cigna	$4,620	33%
Usa Mco-All Plans	$5,050	36%
Quad City Community Hc-All Plans	$6,411	45%
Tricare	$11,327	80%
UnitedHealthcare	$12,000 - $12,586	85%
Aetna	$12,586 - $25,241	89%
Health Alliance Mcare Adv	$12,586	89%
Springfield Armory-All Plans	$15,600	111%
Wellmark Of Ia-All Plans	$16,827	119%
Ambetter / Centene	$19,648	139%
Health Alliance-All Other Plans	$25,241	179%
Multiplan Integrated Hp	$25,241	179%
Multiplan Pponext	$26,924	191%
Osf Direct Access Network-All Plans	$26,924	191%
Multiplan-All Other Plans	$28,607	203%
Corvel-All Plans	$30,289	215%
Hfn-All Plans	$30,289	215%
Multiplan Beech Street	$30,289	215%

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 $30,289.
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 Hammond Henry 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.