Sepsis treatment (inpatient stay)
Facility: Providence Medical Center
Billing Code: 871 (MS-DRG)
- CPT Billing Code: 871
- Insurance Median: $15,064
- Cash Discount Price: $14,526
- vs. Medicare Baseline: 1.07x 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 |
|---|---|---|
| UnitedHealthcare | $9,665 - $20,934 | 68% |
| Medicaid / KanCare | $9,665 | 68% |
| Aetna | $9,858 - $23,805 | 70% |
| Healthy Blue | $9,858 - $15,253 | 70% |
| Celtic | $9,858 - $19,611 | 70% |
| Tricare | $14,074 - $14,526 | 100% |
| Blue Cross Blue Shield | $14,277 - $22,772 | 101% |
| Oha Networks | $14,428 | 102% |
| Midland Care Connection | $14,526 | 103% |
| Medicare (plans) | $14,526 | 103% |
| Cigna | $14,526 | 103% |
| Worker Compensation | $14,875 | 105% |
| Kansas Superior Select | $15,253 | 108% |
| Corizon | $18,884 | 134% |
| Employer Direct Healthcare | $18,884 | 134% |
| Well Path Prison | $20,337 | 144% |
| Centurion | $21,790 | 154% |
| Keenan | $22,050 | 156% |
| Naphcare | $22,516 | 159% |
Consumer Guidance & Cost Commentary
For the procedure code 871, representing sepsis treatment at an inpatient stay, the cash price at Providence Medical Center in Kansas City is $14,526. This cash rate is identical to the facility's negotiated median paid amount of $13,500 and aligns closely with the Medicare benchmark of $14,116.91. While the facility is a voluntary non-profit church-owned acute care hospital, the pricing structure suggests that paying cash upfront could be a cost-effective strategy for patients with high-deductible plans, as the cash price matches the negotiated rates rather than exceeding them. Patients should contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can further reduce the final bill by bypassing administrative claim processing fees.
The data indicates that commercial insurance negotiated rates for this service range widely, from a low of $9,665 with UnitedHealthcare to a high of $22,516 with Naphcare, reflecting significant variation across the 19 payer plans. Although specific state or county average figures were not provided in the dataset, the facility's cash rate remains competitive relative to the Medicare benchmark, which serves as a scientifically validated baseline for healthcare costs. To avoid unexpected charges, patients should request an itemized bill before payment to verify that no unbundled codes or services not rendered are included, ensuring the final amount reflects the agreed-upon negotiated or cash rate rather than the inflated chargemaster list.