CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Ochsner University Hospital and Clinics

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $22,007
Cash Discount Price: $8,116
vs. Medicare Baseline: 1.56x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Ochsner University Hospital and Clinics is $22,007. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,116. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.56x the Medicare baseline. Located in 2390 West Congress, Lafayette, LA.

Cash / Self-Pay

$8,116

Average discount available for prompt cash payment at this facility.

Insurance Median

$22,007

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: $8,116 (57%)

Insurance Median: $22,007 (156%)

Cash: $8,116 (57% of Medicare)

Ins. Median: $22,007 (156% 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
Blue Cross Blue Shield	$14,049 - $22,007	100%
Verity Commercial And First Choice Network	$16,449	117%
UnitedHealthcare	$18,706 - $30,968	133%
Zelis	$18,836	133%
Cigna	$19,105	135%
Tricare	$19,686	139%
Aetna	$22,007	156%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$22,007	156%
Medicare (plans)	$22,007	156%
Ochsner Health Plan	$22,007	156%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$22,668	161%
Wellcare Of Louisiana	$23,108	164%

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 $8,116.
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 Ochsner University Hospital and Clinics 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.