CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: St Tammany Parish Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $11,611
Cash Discount Price: $21,249
vs. Medicare Baseline: 0.82x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at St Tammany Parish Hospital is $11,611. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21,249. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 0.82x the Medicare baseline. Located in 1202 S Tyler Street, Covington, LA.

Cash / Self-Pay

$21,249

Average discount available for prompt cash payment at this facility.

Insurance Median

$11,611

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: $21,249 (151%)

Insurance Median: $11,611 (82%)

Cash: $21,249 (151% of Medicare)

Ins. Median: $11,611 (82% 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
Multiplan	$1,545	11%
UnitedHealthcare	$4,700 - $11,611	33%
Blue Cross Blue Shield	$11,611	82%
Humana	$11,611	82%
Medicare (plans)	$11,611	82%
People'S Health Network	$11,611	82%
Wellcare	$11,611	82%
Tricare	$12,642	90%

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 $21,249.
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 St Tammany Parish Hospital 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.