CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: St Lukes Hospital of Kansas City

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $22,844
Cash Discount Price: $74,598
vs. Medicare Baseline: 1.62x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at St Lukes Hospital of Kansas City is $22,844. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $74,598. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.62x the Medicare baseline. Located in 4401 Wornall Road, Kansas City, MO.

Cash / Self-Pay

$74,598

Average discount available for prompt cash payment at this facility.

Insurance Median

$22,844

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: $74,598 (528%)

Insurance Median: $22,844 (162%)

Cash: $74,598 (528% of Medicare)

Ins. Median: $22,844 (162% 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
Transplants-Case Rates [5750]	$2,200 - $83,173	16%
Humana	$2,335	17%
Cigna	$2,400 - $44,354	17%
UnitedHealthcare	$4,228 - $41,977	30%
Blue Cross Blue Shield	$4,600 - $62,141	33%
Medicaid / KanCare	$7,821 - $8,603	55%
Commercial-Contracted [8000]	$9,543 - $27,549	68%
Medicare (plans)	$14,561 - $18,589	103%
Aetna	$32,036 - $60,260	227%

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 $74,598.
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 St Lukes Hospital of Kansas City 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.