Sepsis treatment (inpatient stay)
Facility: Bob Wilson Memorial Hospital
Billing Code: 871 (MS-DRG)
- CPT Billing Code: 871
- Insurance Median: $22,417
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.59x 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 | $22,417 | 159% |
Consumer Guidance & Cost Commentary
For the procedure "Sepsis treatment (inpatient stay)" at Bob Wilson Memorial Hospital in Ulysses, Kansas, the facility's negotiated rate is $22,417.00, which is significantly higher than the Medicare benchmark of $14,116.91. This indicates a markup of 1.6 times the Medicare amount, a common occurrence where commercial rates exceed the federal baseline due to administrative costs and contract structures. While this facility is a Critical Access Hospital owned by a voluntary non-profit church, the data shows no specific cash or median paid figures available for this service. Patients should be aware that while cash payments can sometimes result in lower out-of-pocket costs for those with high-deductible plans, the absence of a listed cash price here means the negotiated rate may be the primary figure to consider unless the hospital offers a specific self-pay discount upon inquiry.
It is important to note that the No Surprises Act generally protects patients from balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, though unexpected ancillary charges from out-of-network specialists can still occur. If you receive a bill that appears to include charges beyond the negotiated rate, you should request a formal itemized billing audit to identify errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies. Furthermore, if you are paying out-of-pocket, ask the billing department about prompt-pay discounts, which can reduce the total cost by 20% to 50% if settled within 30 days, effectively bypassing the administrative overhead associated with insurance claims processing. Always verify your plan's deductible status before scheduling, as