CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Marion General Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $18,724
Cash Discount Price: $27,054
vs. Medicare Baseline: 1.33x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Marion General Hospital is $18,724. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27,054. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.33x the Medicare baseline. Located in 441 N Wabash Ave, Marion, IN.

Cash / Self-Pay

$27,054

Average discount available for prompt cash payment at this facility.

Insurance Median

$18,724

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: $27,054 (192%)

Insurance Median: $18,724 (133%)

Cash: $27,054 (192% of Medicare)

Ins. Median: $18,724 (133% 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	$14,979	106%
Blue Cross Blue Shield	$14,979 - $38,364	106%
Cigna	$14,979 - $30,109	106%
Humana	$14,979	106%
Lasso_Healthcare	$14,979	106%
Medicare (plans)	$14,979 - $22,468	106%
Exchange_Caresource	$22,468	159%
Exchange_Caresource_Observatio	$22,468	159%
Exchange_Ambest_Mhs	$23,966	170%
Managed_Hlth_Indiana	$23,966	170%
M_Plan_St_Vincent_Cmo	$26,224	186%
Mcclure_Direct_Agreement	$26,224	186%
St_Vincent_Cmo	$26,224	186%
St_Vincent_Transplant	$26,224	186%
Exchange_Blue_Cross	$34,911	247%

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 $27,054.
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 Marion General 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.