Sepsis treatment (inpatient stay)
Facility: Kingman Healthcare Center
Billing Code: 871 (MS-DRG)
- CPT Billing Code: 871
- Insurance Median: $3,520
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.25x 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 | $3,200 | 23% |
| Wellcare | $3,200 | 23% |
| Medicaid / KanCare | $3,200 - $7,172 | 23% |
| UnitedHealthcare | $3,200 | 23% |
| Celtic Insurance Company | $3,200 - $3,520 | 23% |
| Ambetter / Centene | $3,520 | 25% |
| Healthy Blue | $7,172 | 51% |
| Blue Cross Blue Shield | $17,193 | 122% |
Consumer Guidance & Cost Commentary
For the procedure code 871, "Sepsis treatment (inpatient stay)," Kingman Healthcare Center in Kingman, KS, has a negotiated rate range of $3,200 to $7,172 depending on the payer. This facility is a Critical Access Hospital with a voluntary non-profit ownership structure. While the median negotiated rate across payers is $3,520, the Medicare benchmark for this service is significantly higher at $14,116.91. This indicates that the commercial negotiated rates are well below the federal Medicare benchmark, suggesting a pricing structure that aligns with fair market value rather than the inflated chargemaster often used as a comparison point.
Patients should be aware that while in-network insurance contracts cap charges at these negotiated rates, cash-pay options may offer further savings for those with high-deductible plans. The data does not list a specific cash median or negotiated amount, but patients are encouraged to contact the facility directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid upfront. Additionally, because this is an in-network facility, the No Surprises Act generally protects patients from balance billing for out-of-network services rendered at the hospital, though patients should always request an itemized bill to verify that all charges are accurate and that no unbundled codes or services not rendered have been included.