CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Witham Health Services

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $28,250
Cash Discount Price: $27,737
vs. Medicare Baseline: 2.00x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Witham Health Services is $28,250. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27,737. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 2.00x the Medicare baseline. Located in 2605 N Lebanon St, Lebanon, IN.

Cash / Self-Pay

$27,737

Average discount available for prompt cash payment at this facility.

Insurance Median

$28,250

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: $27,737 (196%)

Insurance Median: $28,250 (200%)

Cash: $27,737 (196% of Medicare)

Ins. Median: $28,250 (200% 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 200% of the Medicare baseline (a markup of 100%). 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
Blue Cross Blue Shield	$11,360 - $31,676	80%
Mdwise Health In-All Plans	$14,869	105%
Caresource Mcr Adv	$15,166	107%
Aetna	$15,315 - $29,322	108%
UnitedHealthcare	$22,898	162%
Caresource Indiana Marketplace-All Other Plans	$28,250	200%
Mhs Comml Exch-All Plans	$29,737	211%
Phcs/Multiplan-All Plans	$36,058	255%
Sagamore-All Plans	$36,454	258%
Humana	$36,851	261%
Beech Street-All Plans	$37,245	264%
Encore-All Plans	$37,643	267%

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 $27,737.
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 Witham Health Services 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.