Sepsis treatment (inpatient stay)
Facility: Wesley Medical Center
Billing Code: 871 (MS-DRG)
- CPT Billing Code: 871
- Insurance Median: $15,597
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.10x 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 |
|---|---|---|
| United | $1,926 - $15,597 | 14% |
| Aetna | $2,379 - $15,644 | 17% |
| UnitedHealthcare | $9,680 | 69% |
| Amerigroup | $10,067 | 71% |
| Medicaid / KanCare | $11,345 | 80% |
| First Health | $12,815 | 91% |
| Multiplan | $13,355 | 95% |
| Ambetter / Centene | $14,842 - $16,113 | 105% |
| Humana | $15,644 | 111% |
| Coventry Health Care | $15,644 | 111% |
| Wppa | $15,793 - $22,562 | 112% |
| Devoted Health | $15,957 | 113% |
| Correct Care Solutions | $23,466 | 166% |
| Blue Cross Blue Shield | $26,000 | 184% |
Consumer Guidance & Cost Commentary
For the procedure code 871, representing sepsis treatment at an inpatient stay, the facility's negotiated rates range from $1,926 to $26,000 across 15 different payers, with a median negotiated amount of $15,597. While the facility is located in Wichita, Kansas, the provided data does not include specific county or state average comparisons to contextualize these figures. It is important to note that commercial negotiated rates often exceed the facility's cash price due to administrative costs and contract structures; however, cash-pay options can sometimes be more cost-effective for patients with high-deductible plans if their insurance allowed amounts are significantly higher than the cash rate. Patients should verify their specific plan's allowed amount and inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid upfront.
When reviewing your final invoice, ensure you are looking at an itemized bill rather than a summary statement, as hospitals may obscure individual charges under broad categories like "Laboratory" or "Pharmacy." An itemized audit allows you to identify errors, unbundled codes, or services not rendered, which are common sources of medical debt. For pricing transparency, it is more accurate to compare your facility's rates against the Medicare benchmark of $14,116.91 than to look at the hospital's inflated chargemaster list, which can make discounts appear larger than they are. Since the facility's median negotiated rate of $15,597 is approximately 11% higher than the Medicare rate, this aligns with typical commercial pricing mark