CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: University of Michigan Health - West

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $23,449
Cash Discount Price: $35,582
vs. Medicare Baseline: 1.66x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at University of Michigan Health - West is $23,449. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35,582. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.66x the Medicare baseline. Located in 5900 Byron Center Avenue, Sw, Wyoming, MI.

Cash / Self-Pay

$35,582

Average discount available for prompt cash payment at this facility.

Insurance Median

$23,449

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: $35,582 (252%)

Insurance Median: $23,449 (166%)

Cash: $35,582 (252% of Medicare)

Ins. Median: $23,449 (166% 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
Care Resources	$11,454	81%
Aetna	$12,726 - $25,811	90%
Humana	$12,726 - $13,335	90%
Medicare (plans)	$12,726	90%
Molina Marketplace Commercial	$12,726	90%
Insight Metro Care	$18,326	130%
Golden Rule Ins	$22,711	161%
Medica	$22,711	161%
Student Ins/Mega Life	$22,711	161%
UnitedHealthcare	$22,711	161%
Apwu	$23,449	166%
Cigna	$23,449	166%
Health Partners	$23,449	166%
Priority Health	$23,449	166%
Web Tpa	$23,449	166%
Bcn	$30,481	216%
Blue Cross Blue Shield	$30,481	216%
Alliance Health & Life Ppo	$59,599	422%
Asr Physicians	$59,599	422%
Hap	$59,599	422%
Asr Cofinity	$74,277	526%
Cofinity Commercial	$74,277	526%
Cofinity Weyco	$74,277	526%
Core Source	$74,277	526%
Epoch Group	$74,277	526%
Hlthcomp Admin	$74,277	526%
Mid America	$74,277	526%

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 $35,582.
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 University of Michigan Health - West 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.