CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Franciscan Health Mooresville

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $33,601
Cash Discount Price: $11,757
vs. Medicare Baseline: 2.38x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Franciscan Health Mooresville is $33,601. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,757. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 2.38x the Medicare baseline. Located in 1201 Hadley Rd, Mooresville, IN.

Cash / Self-Pay

$11,757

Average discount available for prompt cash payment at this facility.

Insurance Median

$33,601

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: $11,757 (83%)

Insurance Median: $33,601 (238%)

Cash: $11,757 (83% of Medicare)

Ins. Median: $33,601 (238% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 238% of the Medicare baseline (a markup of 138%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
UnitedHealthcare	$7,791 - $7,950	55%
Commercial [2001]	$7,950 - $49,355	56%
Managed Care [2000]	$7,950 - $49,355	56%
United Medical Resources [1158]	$7,950	56%
United Medical Resources [1301]	$7,950	56%
Medicare (plans)	$16,800 - $18,480	119%
Blue Cross Blue Shield	$29,138 - $44,035	206%
Workers Comp [1172]	$33,601	238%
Unicare [1150]	$44,035	312%
Aetna	$49,355	350%

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 $11,757.
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 Franciscan Health Mooresville 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.