Sepsis treatment (inpatient stay)
Facility: Children'S Mercy South
Billing Code: 871 (MS-DRG)
- CPT Billing Code: 871
- Insurance Median: $9,736
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.69x 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 | $8,928 | 63% |
| Healthy Blue | $9,523 | 67% |
| Medicaid / KanCare | $9,949 | 70% |
| Blue Cross Blue Shield | $41,548 | 294% |
Consumer Guidance & Cost Commentary
For the procedure "Sepsis treatment (inpatient stay)" at Children's Mercy South in Overland Park, KS, the facility's negotiated rates vary significantly by payer, ranging from $8,928 for UnitedHealthcare to $41,548 for Blue Cross Blue Shield. While the median negotiated rate across all payers is $9,736, this amount is notably higher than the Medicare benchmark of $14,116.91, which serves as the federal baseline for fair pricing. It is important to note that commercial negotiated rates often include administrative overhead and contract premiums that can inflate the final cost, and patients should verify their specific plan's allowed amount before scheduling to ensure they are not paying above the contract ceiling.
Patients should be aware that cash-pay options may offer a lower total cost if the insurance negotiated rate exceeds the cash price, particularly for those with high-deductible plans. Although cash and median paid figures are not currently listed for this specific code, the facility, a voluntary non-profit, may offer "self-pay" or "prompt-pay" discounts that could reduce the bill by 20% to 50% if paid in full upfront. To avoid unexpected balance billing or administrative fees, it is recommended to request a waiver of insurance submission at registration and always obtain a detailed, itemized bill before making any payments to ensure accuracy and transparency.