CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Massac Memorial Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $4,939
Cash Discount Price: $4,683
vs. Medicare Baseline: 0.35x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Massac Memorial Hospital is $4,939. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,683. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 0.35x the Medicare baseline. Located in 28 Chick Street, Po Box 850, Metropolis, IL.

Cash / Self-Pay

$4,683

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,939

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: $4,683 (33%)

Insurance Median: $4,939 (35%)

Cash: $4,683 (33% of Medicare)

Ins. Median: $4,939 (35% 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	$1,545 - $4,939	11%
Blue Cross Blue Shield	$3,345 - $6,422	24%
Prime Health Services-All Plans	$4,683	33%
Healthlink Hmo	$4,903	35%
Health Alliance Mcare Adv	$4,939	35%
Humana	$4,939	35%
Molina Ky Mcaid	$4,939	35%
Healthlink Ppo-All Other Plans	$5,499	39%
Cigna	$5,512	39%
UnitedHealthcare	$5,619	40%
Multiplan-All Plans	$6,020	43%

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 $4,683.
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 Massac 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.