Sepsis treatment (inpatient stay)
Facility: Kansas Spine & Specialty Hospital, Llc
Billing Code: 871 (MS-DRG)
- CPT Billing Code: 871
- Insurance Median: $12,689
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.90x 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 | $9,001 - $12,689 | 64% |
| Humana | $12,435 | 88% |
| Providrs Care Network | $12,689 - $16,939 | 90% |
| Aetna | $12,689 - $16,877 | 90% |
| United Mine Workers Of America | $12,689 | 90% |
| UnitedHealthcare | $12,689 | 90% |
| Lantern Specialty Care | $20,303 | 144% |
Consumer Guidance & Cost Commentary
For the procedure "Sepsis treatment (inpatient stay)" at Kansas Spine & Specialty Hospital, Llc in Wichita, KS, the negotiated rates range from $9,001 to $20,303 depending on the insurance carrier. While the median negotiated rate across payers is $12,689, patients should be aware that cash-pay options may offer lower costs, particularly for those with high-deductible plans where the insurance allowed amount exceeds the cash price. It is important to note that cash prices are not explicitly listed in this report; however, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can significantly lower out-of-pocket expenses by bypassing administrative processing costs.
This facility operates as an Acute Care Hospital with a physician-owned structure, and its pricing is benchmarked against federal standards. The Medicare amount for this service is $14,116.91, which serves as the objective baseline for evaluating commercial rate markups. Commercial negotiated rates often average between 200% and 300% of Medicare, though fair pricing is typically defined as 120% to 150% of this federal rate. Since no specific county or state average data was provided in the source material, patients should rely on the Medicare benchmark to understand the true cost of care rather than comparing discounts against inflated chargemaster lists. If a patient receives a bill that appears to include balance billing for out-of-network services at this in-network facility, they should verify the legality of the charge under the No Surprises Act and request a formal itemized audit to identify any unbundled