CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Lowell General Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $17,418
Cash Discount Price: $19,689
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Lowell General Hospital is $17,418. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19,689. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.23x the Medicare baseline. Located in 295 Varnum Avenue, Lowell, MA.

Cash / Self-Pay

$19,689

Average discount available for prompt cash payment at this facility.

Insurance Median

$17,418

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: $19,689 (139%)

Insurance Median: $17,418 (123%)

Cash: $19,689 (139% of Medicare)

Ins. Median: $17,418 (123% 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
Medicare (plans)	$1,971 - $17,755	14%
Aetna	$4,540 - $17,418	32%
Meritain [100063]	$4,540	32%
Elementcare [450046]	$6,359	45%
Champva [800006]	$16,967	120%
UnitedHealthcare	$16,967 - $17,755	120%
Veterans Services [800005]	$16,967	120%
Cigna	$17,418 - $29,627	123%
Fallon Senior [450065]	$17,418 - $17,755	123%
Harvard Pilgrim Stride [450060]	$17,418	123%
Humana	$17,418	123%
Martins Point Generations Replacement [450057]	$17,418	123%
Medicaid / KanCare	$17,418 - $17,755	123%
Neighborhood Pace [450114]	$17,418	123%
Peak Pace Solutions [450115]	$17,418	123%
Secure Horizons Ma Pffs [450077]	$17,418	123%
Veterans Evaluation Svcs [800004]	$17,418	123%
Blue Cross Blue Shield	$17,755	126%
Commonwealth Care Alliance [450067]	$17,755	126%
Wellpoint [100139]	$24,225	172%
Fallon Health Connectorcare [100260]	$27,698	196%
Fallon Health [100259]	$27,698	196%
Health Safety Net [500011]	$72,691	515%

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 $19,689.
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 Lowell General 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.