CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Ochsner Medical Center Acute

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $32,647
Cash Discount Price: $12,359
vs. Medicare Baseline: 2.31x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Ochsner Medical Center Acute is $32,647. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12,359. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 2.31x the Medicare baseline. Located in 1516 Jefferson Hwy, New Orleans, LA.

Cash / Self-Pay

$12,359

Average discount available for prompt cash payment at this facility.

Insurance Median

$32,647

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: $12,359 (88%)

Insurance Median: $32,647 (231%)

Cash: $12,359 (88% of Medicare)

Ins. Median: $32,647 (231% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 231% of the Medicare baseline (a markup of 131%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Medicaid / KanCare	$10,383 - $31,657	74%
Christus Health Exchange Plan	$13,080	93%
Louisiana Workers' Compensation Corporation (Lwcc)	$13,930 - $74,405	99%
Healthcomp & Personify Health (Formerly Gilsbar)	$14,968 - $79,952	106%
Tricare	$15,066	107%
UnitedHealthcare	$15,141 - $36,417	107%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$15,938	113%
Blue Cross Blue Shield	$15,938 - $34,984	113%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$15,938	113%
Humana	$15,938	113%
Medicare (plans)	$15,938	113%
Ochsner Health Plan	$15,938	113%
Pace New Orleans	$17,532	124%
Mississippi Physicians Care Network	$18,995 - $101,462	135%
Employers Health Network (Ehn)	$21,528 - $114,990	152%
Prime Health Services Ppo	$21,528 - $114,990	152%
Usa Managed Care Network	$21,528 - $114,990	152%
Behavioral Health Systems	$22,794 - $121,754	161%
Evolutions Healthcare	$22,794 - $121,754	161%
Galaxy Health Network Ppo	$22,794 - $121,754	161%
Galaxy Health Network Wc	$22,794 - $121,754	161%
Cigna	$27,126	192%
Aetna	$28,062 - $30,503	199%

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 $12,359.
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 Medical Center Acute 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.