Sepsis treatment (inpatient stay)
Facility: Scott County Hospital
Billing Code: 871 (MS-DRG)
- CPT Billing Code: 871
- Insurance Median: $4,571
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.32x 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 | $7,942 | 56% |
Consumer Guidance & Cost Commentary
For the procedure "Sepsis treatment (inpatient stay)" at Scott County Hospital in Scott City, KS, the facility's negotiated rate of $4,571.00 is significantly lower than the Medicare benchmark of $14,116.91, reflecting a markup of only 32% compared to the typical 200% to 300% range seen in commercial pricing. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the data indicates no specific cash or median paid values were reported for this service. However, for patients with high-deductible plans, paying the cash price directly can sometimes be more affordable if the insurance negotiated rate exceeds the cash price, though current data does not confirm a cash rate for this specific code.
To minimize potential costs, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can range from 20% to 50% off the billed amount when paid in full upfront. This discount bypasses the administrative overhead associated with insurance claims processing and provides immediate liquidity to the facility. Since the data shows no balance billing risks for this in-network service at this facility, the focus should remain on verifying the final allowed amount before scheduling. Consumers are encouraged to request a detailed, itemized bill to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be resolved through a formal written audit dispute.