CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Baptist Health Hardin

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $23,415
Cash Discount Price: $52,185
vs. Medicare Baseline: 1.66x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Baptist Health Hardin is $23,415. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $52,185. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.66x the Medicare baseline. Located in 913 North Dixie Avenue, Elizabethtown, KY.

Cash / Self-Pay

$52,185

Average discount available for prompt cash payment at this facility.

Insurance Median

$23,415

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$14,116.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $14,116.91 (100%)

Cash / Self-Pay: $52,185 (370%)

Insurance Median: $23,415 (166%)

Cash: $52,185 (370% of Medicare)

Ins. Median: $23,415 (166% of 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Wellcare Mcaid	$10,556 - $15,809	75%
Aetna	$11,405 - $39,063	81%
Blue Cross Blue Shield	$12,133 - $69,580	86%
Humana	$12,133 - $31,290	86%
Molina Mcaid - All Plans	$12,133 - $12,647	86%
UnitedHealthcare	$12,133 - $58,680	86%
Sig Advantage - All Plans	$13,067	93%
Wellcare Mcr Adv - All Other Plans	$13,067 - $13,916	93%
Wellmark Mcr Adv - All Plans	$13,067 - $13,916	93%
Signature Adv - All Plans	$13,916	99%
Phcs-All Plans	$14,592 - $38,684	103%
Cigna	$19,409 - $24,172	137%
Siho Exclus Ntwrk	$19,425	138%
Siho Dual Ntwrk	$23,310	165%
Caresource-All Plans	$23,520 - $27,660	167%
Healthlink-All Plans	$23,831 - $24,079	169%
Siho Ppo - All Other Plans	$27,195	193%
Siho-All Plans	$27,195	193%
Center Care - All Plans	$30,394	215%
Encore Preferred	$35,138	249%
Multiplan-All Plans	$52,378 - $54,968	371%
Center Care-All Plans	$55,077	390%
Encore Ppo - All Other Plans	$59,769	423%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $52,185.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 871.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Baptist Health Hardin is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 871.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.