CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: SSM St Clare Health Center

Billing Code: 871 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$17,402

about 1.2× the $14,117 Medicare rate · typically $15,165–$22,028

modeled estimate · not a bill or quote

What this hospital charges insurers

$15,061

Below the fair price — a good deal

about $2,341 under the fair price · 1.1× Medicare

Medicare pays $14,117 Fair price $17,402 This hospital $15,061

How we calculate the fair BaseRate →

How this hospital compares to other MO hospitals

Highest price of the 9 MO hospitals we have prices for — worth calling around.

Cheapest $8,760 Priciest $15,061

Black dot = this hospital, among the 9 MO hospitals with a price for this procedure. Full list below.

A fair price for a Sepsis treatment (inpatient stay) is about $17,402 (about 1.2× the $14,117 Medicare rate). SSM St Clare Health Center charges insurers about $15,061 — below the fair price — a good deal. Located in Fenton, MO.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$14,809 - $25,422	105%
Blue Cross Blue Shieldmajor	$15,031 - $34,285	106%
Aetnamajor	$14,809 - $22,844	105%
Cignamajor	$24,413	173%
Humanamajor	$15,061	107%
Ambetter (Centene)	$14,809 - $18,131	105%
HealthLink	$13,885 - $35,875	98%
Medica	$13,941 - $14,809	99%
Molina	$14,809	105%
Oscar Health	$22,727	161%
+ 3 smaller / regional plans	$14,809 - $14,957

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 871.

Insurance Before you use insurance

Call your insurance company to confirm SSM St Clare Health Center is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 871.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at SSM St Clare Health Center

Compare: Sepsis treatment (inpatient stay) at other MO hospitals

The Children's Mercy Hospital · Kansas City $8,760
Mosaic Life Care at St Joseph · Saint Joseph $8,876
Long Term Acute Care Hospital Mosaic Life Care at St Joseph · Saint Joseph $8,876
Cass Regional Medical Center · Harrisonville $9,859
Mercy Hospital Aurora · Aurora $11,600
Mercy Hospital - Cassville · Cassville $11,600
Mercy Hospital Carthage · Carthage $12,418
University Health Lakewood Medical Center · Kansas City $12,558

Insurance negotiated median for the same procedure, sorted lowest first.