CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Daviess Community Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $15,242
Cash Discount Price: $10,759
vs. Medicare Baseline: 1.08x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Daviess Community Hospital is $15,242. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,759. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.08x the Medicare baseline. Located in 1314 E Walnut St, Washington, IN.

Cash / Self-Pay

$10,759

Average discount available for prompt cash payment at this facility.

Insurance Median

$15,242

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: $10,759 (76%)

Insurance Median: $15,242 (108%)

Cash: $10,759 (76% of Medicare)

Ins. Median: $15,242 (108% 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
Caresource Mcaid-All Plans	$4,406	31%
Hoosier Healthwise Mcaid-All Plans	$4,406	31%
Patoka Valley-All Plans	$7,685	54%
St. Vincent Health - All Plans	$9,990	71%
Aetna	$12,296 - $15,115	87%
Encore Ppo-All Plans	$12,680	90%
Siho-All Plans	$13,833	98%
Sagamore Valley-All Plans	$14,909	106%
Blue Cross Blue Shield	$15,115 - $15,370	107%
Humana	$15,370	109%
Mdwise Marketplace-All Plans	$15,370	109%
UnitedHealthcare	$15,373	109%

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 $10,759.
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 Daviess Community 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.