CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Perham Health

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $6,320
Cash Discount Price: $13,136
vs. Medicare Baseline: 0.45x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Perham Health is $6,320. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13,136. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 0.45x the Medicare baseline. Located in 1000 Coney Street West, Perham, MN.

Cash / Self-Pay

$13,136

Average discount available for prompt cash payment at this facility.

Insurance Median

$6,320

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: $13,136 (93%)

Insurance Median: $6,320 (45%)

Cash: $13,136 (93% of Medicare)

Ins. Median: $6,320 (45% 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
Ucare Mn Medical Assistance	$3,956	28%
Ucare Mn Minnesota Care	$3,956	28%
Ucare Mn Senior Care Plus	$3,956	28%
Ucare Mn Special Needs Basic Care	$3,956	28%
UnitedHealthcare	$5,369 - $13,540	38%
Medicaid / KanCare	$5,530	39%
Blue Cross Blue Shield	$5,610 - $11,897	40%
Health Partners Mcr Adv	$6,019	43%
Humana	$6,019	43%
Medica Mcr Adv	$6,019	43%
Medicare (plans)	$6,019 - $6,320	43%
Ucare Mn Senior Health Options	$6,320	45%
Ucare Mn Special Needs Basic Care Dual	$6,320	45%
Ucare Individual And Family Plan-All Other Plans	$6,922	49%
Medica Mcaid Mn Care	$8,298	59%
Health Partners Minnesota Care	$10,104	72%
Medica Mn (Msho)	$12,719	90%
Medica Mn Senior Hp/Outside Mn	$12,719	90%
Preferred One (Pchp, Pic, Pas)-All Other Plans	$15,157	107%
Health Partners-All Plans	$16,571	117%
Preferred One (Ppo)	$17,178	122%
Sanford Health Plan-All Plans	$17,178	122%
Medica Commercial-All Other Plans	$25,884	183%

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 $13,136.
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 Perham Health 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.