CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Lake Cumberland Regional Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $15,395
  • Cash Discount Price: $39,455
  • vs. Medicare Baseline: 1.09x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Lake Cumberland Regional Hospital is $15,395. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39,455. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.09x the Medicare baseline. Located in 305 Langdon Street, Somerset, KY.
Cash / Self-Pay
$39,455

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,395

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: $39,455 (279%)
Insurance Median: $15,395 (109%)
Cash: $39,455 (279% of Medicare)
Ins. Median: $15,395 (109% 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.

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
UnitedHealthcare $3,196 - $15,703 23%
Aetna $14,623 104%
Devoted Health $14,623 104%
Blue Cross Blue Shield $15,395 - $26,112 109%
Definity $15,395 109%
Humana $15,395 109%
Pyramid $15,395 109%
Secure Horizons $15,395 109%
Sterling $15,395 109%
Unicare $15,395 109%
Bluegrass Family Health $15,703 111%
Amerigroup $16,165 115%
Tricare $16,311 116%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 305 Langdon Street, Somerset, KY 42503
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals