Sepsis treatment (inpatient stay)
Facility: Saint Luke'S South Hospital
Billing Code: 871 (MS-DRG)
- CPT Billing Code: 871
- Insurance Median: $23,431
- Cash Discount Price: $57,367
- vs. Medicare Baseline: 1.66x 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 |
|---|---|---|
| Humana | $2,900 - $26,000 | 21% |
| Cigna | $3,100 - $44,354 | 22% |
| Transplants-Case Rates [5750] | $4,300 - $83,173 | 30% |
| UnitedHealthcare | $4,716 - $31,505 | 33% |
| Blue Cross Blue Shield | $4,870 - $60,509 | 34% |
| Commercial-Contracted [8000] | $5,418 - $20,863 | 38% |
| Medicaid / KanCare | $9,680 - $10,648 | 69% |
| Medicare (plans) | $13,039 - $13,691 | 92% |
| Aetna | $30,383 - $60,260 | 215% |
Consumer Guidance & Cost Commentary
For the procedure code 871, representing sepsis treatment at Saint Luke's South Hospital in Overland Park, KS, the facility's cash median price is $57,367.00, while the median negotiated rate across payers is $23,431.00. It is important to note that commercial insurance rates often exceed cash prices due to administrative overhead and contract structures; therefore, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, which could result in out-of-pocket costs exceeding the cash rate if deductibles are not yet met. Before scheduling, patients should explicitly request "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid upfront, bypassing the costly claims processing cycle that inflates insurance rates.
The facility's Medicare benchmark rate for this service is $14,116.91, which serves as the objective baseline for evaluating pricing markup. While the data provided does not include specific state or county average figures for comparison, the facility's Medicare rate of $14,116.91 is significantly lower than the commercial negotiated rates observed, such as the $30,383.00 low end for Aetna plans. To ensure you are receiving fair pricing, it is recommended to request a full itemized billing audit rather than accepting a summary bill, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. If you receive a balance bill from an out-of-network provider, you may be protected under the No Surprises Act, which bans balance