CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: The Women's Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $22,273
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.58x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at The Women's Hospital is $22,273. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.58x the Medicare baseline. Located in 4199 Gateway Blvd, Newburgh, IN.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$22,273

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%)

Insurance Median: $22,273 (158%)

Ins. Median: $22,273 (158% 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
Amish	$8,909	63%
Aetna	$15,219 - $19,911	108%
Humana	$15,219 - $22,273	108%
Passport Molina Ky	$15,219	108%
UnitedHealthcare	$15,219 - $31,626	108%
Wellcare Ky	$15,219 - $22,273	108%
Blue Cross Blue Shield	$22,273 - $31,956	158%
Caresource	$22,273	158%
Immergrun	$22,273	158%
Iu Health	$22,273	158%
Meridian Health Il	$22,273	158%
Mhs	$22,273	158%
Molina Il	$22,273	158%
Molina Ky	$22,273	158%
Molina Ky Dual	$22,273	158%
Alliance Coal	$23,826	169%
Encoreprime	$30,467	216%
Claritev (Formerly Phcs/Mulitplan)	$31,634	224%
Claimdoc	$32,296	229%
One Care	$33,404	237%
Caresource Marketplace (Just4Me)	$33,409	237%
Hst	$33,409	237%
Chamber Care	$33,512	237%
Ambetter / Centene	$35,636	252%
Noncontracted	$35,636	252%
Cigna	$35,763	253%
Sagamore	$35,763	253%
Hope Trust	$36,750	260%
Allied National/Zelis - Freedom Plan	$54,568	387%

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 $X.
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 The Women's 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.