Sepsis treatment (inpatient stay)
Facility: Select Specialty Hospital - Kansas City
Billing Code: 871 (MS-DRG)
- CPT Billing Code: 871
- Insurance Median: $1,700
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.12x 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 |
|---|---|---|
| Aetna | $1,615 - $1,880 | 11% |
| Cigna | $1,682 | 12% |
| Phcs-Multiplan | $1,700 | 12% |
| Wppa | $1,801 | 13% |
| UnitedHealthcare | $1,836 | 13% |
| Healthcare Highways | $1,957 | 14% |
| Sidecare Health Insurance Solutions | $2,400 | 17% |
Consumer Guidance & Cost Commentary
For the procedure code 871, representing sepsis treatment in an inpatient stay at the Select Specialty Hospital in Kansas City, the negotiated rates range from $1,615 to $2,400 depending on the insurance carrier. These commercial rates are significantly higher than the Medicare benchmark of $14,116.91, which serves as the objective baseline for evaluating hospital pricing markup. It is important to note that while commercial rates appear lower than the Medicare amount in this specific dataset due to the nature of the comparison metric, patients should be aware that commercial negotiated rates often include administrative overhead and contract dynamics that can inflate the baseline price by 20% to 40%. For patients with high-deductible plans, paying the cash price or utilizing a prompt-pay discount may result in lower out-of-pocket costs compared to the insurance negotiated rate, provided the cash price is below the insurer's allowed amount.
To minimize financial risk, patients should verify their specific plan's deductible status before scheduling, as high negotiated rates may not apply until the annual deductible is met. Additionally, it is crucial to request a self-pay or prompt-pay discount prior to check-in, as hospitals often offer fee reductions of 20% to 50% for upfront payment that bypasses costly claims processing. If a balance bill arises from out-of-network ancillary services, patients should utilize the No Surprises Act protections to dispute the charge rather than paying immediately out of fear. Finally, always demand a full itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be corrected through a formal written dispute.