Sepsis treatment (inpatient stay)
Facility: Kansas Heart Hospital
Billing Code: 871 (MS-DRG)
- CPT Billing Code: 871
- Insurance Median: $12,604
- Cash Discount Price: $18,372
- vs. Medicare Baseline: 0.89x 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 | $9,181 - $9,680 | 65% |
| Celtic Mcaid - All Other Plans | $9,680 | 69% |
| UnitedHealthcare | $9,680 - $13,879 | 69% |
| Medicaid / KanCare | $9,680 - $12,764 | 69% |
| Soonerselect Mcaid - All Plans | $9,680 | 69% |
| Tricare | $11,487 | 81% |
| Aetna | $12,445 - $12,764 | 88% |
| Celtic Mcr Adv | $12,764 | 90% |
| Humana | $12,764 | 90% |
| Multiplan - All Plans | $25,998 | 184% |
Consumer Guidance & Cost Commentary
For the procedure "Sepsis treatment (inpatient stay)" at Kansas Heart Hospital in Wichita, KS, the facility's cash median price is $18,372.00, which is lower than the negotiated rates paid by most major insurers. While the hospital's gross charge is $29,162.00, commercial payers such as UnitedHealthcare and Aetna have negotiated rates ranging from $9,680 to $13,879, and Medicaid/KanCare rates fall between $9,680 and $12,764. This suggests that for patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $18,372.00 upfront could result in significant savings compared to the higher allowed amounts or negotiated rates that insurance carriers are contractually obligated to pay.
To maximize financial protection, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling their visit, as these upfront payment incentives can further reduce the final bill by bypassing administrative claim processing fees. It is also important to note that while the facility is in-network for many plans, the No Surprises Act protects patients from balance billing for out-of-network services at this acute care hospital, though patients should still verify their specific plan details to ensure no unexpected ancillary charges occur. For context on regional pricing, this facility's cash rate is notably lower than the median negotiated rates observed across other payers, indicating a favorable position for direct payers compared to the broader market average.