CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Saint Luke's East Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $23,289
Cash Discount Price: $67,305
vs. Medicare Baseline: 1.65x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Saint Luke's East Hospital is $23,289. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $67,305. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.65x the Medicare baseline. Located in 100 N E Saint Luke's Boulevard, Lees Summit, MO.

Cash / Self-Pay

$67,305

Average discount available for prompt cash payment at this facility.

Insurance Median

$23,289

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: $67,305 (477%)

Insurance Median: $23,289 (165%)

Cash: $67,305 (477% of Medicare)

Ins. Median: $23,289 (165% 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
Humana	$2,900 - $26,000	21%
Cigna	$3,100 - $26,407	22%
Transplants-Case Rates [5750]	$4,300 - $83,173	30%
UnitedHealthcare	$4,716 - $31,505	33%
Blue Cross Blue Shield	$4,870 - $67,852	34%
Commercial-Contracted [8000]	$5,562 - $22,155	39%
Medicaid / KanCare	$8,715 - $9,064	62%
Medicare (plans)	$13,847 - $14,539	98%
Aetna	$30,383 - $60,260	215%

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 $67,305.
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 Saint Luke's East Hospital 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.