Sepsis treatment (inpatient stay)
Facility: Saint John Hospital
Billing Code: 871 (MS-DRG)
- CPT Billing Code: 871
- Insurance Median: $13,399
- Cash Discount Price: $12,946
- vs. Medicare Baseline: 0.95x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
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 | $8,346 - $16,692 | 59% |
| Medicaid / KanCare | $8,872 | 63% |
| UnitedHealthcare | $8,872 - $18,125 | 63% |
| Celtic | $9,050 - $17,477 | 64% |
| Healthy Blue | $9,050 - $13,594 | 64% |
| Aetna | $12,946 - $20,031 | 92% |
| Tricare | $12,946 - $13,937 | 92% |
| Midland Care Connection | $12,946 | 92% |
| Medicare (plans) | $12,946 | 92% |
| Cigna | $12,946 | 92% |
| Kansas Superior Select | $13,205 | 94% |
| Oha Networks | $14,428 | 102% |
| Worker Compensation | $14,875 | 105% |
| Employer Direct Healthcare | $16,830 | 119% |
| Well Path | $18,125 | 128% |
| Corizon | $18,125 | 128% |
| Centurion | $19,419 | 138% |
| Naphcare | $20,067 | 142% |
Consumer Guidance & Cost Commentary
For the procedure code 871, representing sepsis treatment in an inpatient stay at Saint John Hospital in Leavenworth, KS, the cash median price is $12,946. This rate is notably lower than the facility's negotiated rates, which range from $8,346 to $20,067 depending on the insurance carrier. While the facility's negotiated rates generally align with or exceed the national average for this service, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as commercial negotiated rates often include administrative overhead that inflates the final bill. To secure the lowest possible cost, patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as hospitals frequently offer significant reductions for upfront payment that bypass the standard insurance billing cycle.
When evaluating the financial impact of this care, it is important to compare the facility's pricing against the Medicare benchmark, which serves as the most reliable indicator of true cost. The Medicare amount for this service is $14,116.91, and the facility's cash rate of $12,946 represents a 90% ratio to the Medicare amount, indicating a pricing structure that is competitive and below the typical commercial markup. Although the facility is a voluntary non-profit acute care hospital, the wide variance in negotiated rates across different payers—ranging from Medicaid's fixed rate of $8,872 to employer direct rates of $16,830—highlights the importance of verifying your specific plan's allowed amount. Consumers should avoid accepting summary bills and instead request a detailed itemized audit to ensure no unbund