CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: St Claire Regional Medical Center

Billing Code: 871 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$15,668

about 1.1× the $14,117 Medicare rate · typically $13,396–$25,581

modeled estimate · not a bill or quote

What this hospital charges insurers

$15,845

About the fair price

about $177 over the fair price · 1.1× Medicare

Medicare pays $14,117 Fair price $15,668 This hospital $15,845 Cash price $26,517 Hospital's list price $35,355

How we calculate the fair BaseRate →

How this hospital compares to other KY hospitals

Highest price of the 9 KY hospitals we have prices for — worth calling around.

Cheapest $13,022 Priciest $15,845

Black dot = this hospital, among the 9 KY hospitals with a price for this procedure. Full list below.

A fair price for a Sepsis treatment (inpatient stay) is about $15,668 (about 1.1× the $14,117 Medicare rate). St Claire Regional Medical Center charges insurers about $15,845, or about $26,517 in cash — about the fair price. Located in Morehead, KY.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ Blue Cross Blue Shield✓ Aetna✓ Humana UnitedHealthcareCignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
Blue Cross Blue Shieldmajor	$14,654 - $24,508	104%
Aetnamajor	$11,568	82%
Humanamajor	$14,654 - $24,749	104%
CareSource	$14,654 - $19,050	104%
HealthLink	$14,821	105%
WellCare	$12,574 - $30,052	89%
+ 1 smaller / regional plan	$19,050

Government programs also on file: Medicaid.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 26,517), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 871.

Insurance Before you use insurance

Call your insurance company to confirm St Claire Regional Medical Center is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 871.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at St Claire Regional Medical Center

Compare: Sepsis treatment (inpatient stay) at other KY hospitals

Murray-Calloway County Hospital · Murray $13,022
Taylor Regional Hospital · Campbellsville $13,436
Tristar Greenview Regional Hospital · Bowling Green $13,533
Tj Health Columbia · Columbia $13,564
Georgetown Community Hospital · Georgetown $13,659
Bourbon Community Hospital · Paris $13,828
Saint Joseph London · London $14,008
Clark Regional Medical Center · Winchester $14,036

Insurance negotiated median for the same procedure, sorted lowest first.