CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Ochsner Medical Center - Baton Rouge

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $22,483
Cash Discount Price: $11,662
vs. Medicare Baseline: 1.59x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Ochsner Medical Center - Baton Rouge is $22,483. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,662. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.59x the Medicare baseline. Located in 17000 Medical Center Dr, Baton Rouge, LA.

Cash / Self-Pay

$11,662

Average discount available for prompt cash payment at this facility.

Insurance Median

$22,483

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: $11,662 (83%)

Insurance Median: $22,483 (159%)

Cash: $11,662 (83% of Medicare)

Ins. Median: $22,483 (159% 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
Medicaid / KanCare	$3,854 - $30,149	27%
Louisiana Workers' Compensation Corporation (Lwcc)	$9,266 - $101,780	66%
Healthcomp & Personify Health (Formerly Gilsbar)	$10,109 - $111,032	72%
Mississippi Physicians Care Network	$12,636 - $138,790	90%
Tricare	$13,098	93%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$14,177	100%
Blue Cross Blue Shield	$14,177 - $28,001	100%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$14,177	100%
Humana	$14,177	100%
Medicare (plans)	$14,177	100%
Ochsner Health Plan	$14,177	100%
UnitedHealthcare	$14,177 - $36,764	100%
Prime Health Services Ppo	$14,320 - $157,296	101%
Usa Managed Care Network	$14,320 - $157,296	101%
Aetna	$21,887	155%
Cigna	$24,067	170%

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 $11,662.
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 - Baton Rouge 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.