CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Central Maine Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $15,822
Cash Discount Price: $15,821
vs. Medicare Baseline: 1.12x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Central Maine Medical Center is $15,822. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15,821. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.12x the Medicare baseline. Located in 300 Main Street, Lewiston, ME.

Cash / Self-Pay

$15,821

Average discount available for prompt cash payment at this facility.

Insurance Median

$15,822

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: $15,821 (112%)

Insurance Median: $15,822 (112%)

Cash: $15,821 (112% of Medicare)

Ins. Median: $15,822 (112% 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	$13,580	96%
Aetna	$15,224 - $42,185	108%
Blue Cross Blue Shield	$15,224 - $35,101	108%
Humana	$15,224	108%
UnitedHealthcare	$15,224 - $46,860	108%
Wellcare	$15,224	108%
Medicare (plans)	$15,822	112%
Self-Pay	$15,822	112%
Workers Compensation	$21,604	153%
Martins Point	$29,847	211%
Tricare	$29,847	211%
Cigna	$39,874	282%
Multiplan	$46,752	331%

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 $15,821.
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 Central Maine Medical Center 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.