Sepsis treatment (inpatient stay)
Facility: Mcpherson Hospital
Billing Code: 871 (MS-DRG)
- CPT Billing Code: 871
- Insurance Median: $14,280
- Cash Discount Price: $27,824
- vs. Medicare Baseline: 1.01x 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 |
|---|---|---|
| Medicaid / KanCare | $7,942 | 56% |
| UnitedHealthcare | $7,942 - $29,328 | 56% |
| Health Blue Mcaid - All Other Plans | $8,101 | 57% |
| Tricare | $10,928 | 77% |
| Aetna | $12,418 - $31,020 | 88% |
| Wellcare Mcr Adv - All Plans | $12,418 | 88% |
| Humana | $12,418 | 88% |
| Blue Cross Blue Shield | $12,418 | 88% |
| Va Ccn - All Plans | $12,418 | 88% |
| Ambetter / Centene | $14,280 | 101% |
| Wppa - All Plans | $22,936 | 162% |
| Medical Associates - All Plans | $28,200 | 200% |
| Central Plains - All Plans | $28,200 | 200% |
| Christian Health Aid - All Plans | $30,080 | 213% |
| Multiplan - All Plans | $33,840 | 240% |
| First Health - All Plans | $35,720 | 253% |
| Cigna | $35,720 | 253% |
| Health Partners - All Plans | $35,720 | 253% |
Consumer Guidance & Cost Commentary
For the Sepsis treatment (inpatient stay) code at McPherson Hospital in Mcpherson, KS, the facility's cash median rate is $27,824, which is lower than the median negotiated rate of $30,550. This suggests that patients with high-deductible plans or those without insurance may save money by paying cash directly, as the cash price is below the amount commercial insurers typically negotiate. While the facility's negotiated rate of $14,280 is significantly lower than the gross charge of $37,600, it remains higher than the Medicare benchmark of $14,116.91, indicating a markup of approximately 1.0x compared to the federal baseline. To maximize savings, patients should inquire about "self-pay" or "prompt-pay" discounts before scheduling, as paying upfront can often reduce the final bill by 20% to 50% by bypassing administrative claim processing fees.
The pricing landscape for this service varies widely among payers, with rates ranging from $7,942 for Medicaid/KanCare plans up to $35,720 for certain commercial plans like Cigna and Health Partners. Although the data does not provide specific state or county average figures for comparison, the facility's location in Mcpherson (ZIP 67460) and its status as a voluntary non-profit acute care hospital are relevant context for understanding regional pricing norms. Patients should be aware that balance billing is generally prohibited for emergency services under the No Surprises Act, but it is crucial to verify network status and deductible coverage before receiving care to avoid unexpected out-of-pocket costs. If a patient