CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Wayne General Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $12,357
Cash Discount Price: $20,800
vs. Medicare Baseline: 0.88x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Wayne General Hospital is $12,357. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20,800. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 0.88x the Medicare baseline. Located in 950 Matthew Dr, Waynesboro, MS.

Cash / Self-Pay

$20,800

Average discount available for prompt cash payment at this facility.

Insurance Median

$12,357

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: $20,800 (147%)

Insurance Median: $12,357 (88%)

Cash: $20,800 (147% of Medicare)

Ins. Median: $12,357 (88% 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
Healthcare Advantage-All Plans	$3,060	22%
Phcs-All Plans	$3,600	26%
Ms Health Partners-All Plans	$3,640	26%
Ppoplus-All Plans	$3,800	27%
Ahs-All Plans	$5,144	36%
Cigna	$5,950 - $12,357	42%
Humana	$7,414	53%
Ml Healthcare-All Plans	$8,320	59%
Magnolia Comm/Exchange-All Other Plans	$9,487	67%
Aetna	$12,357	88%
Amerigroup Mcare Adv-All Plans	$12,357	88%
Magnolia Mcare Adv	$12,357	88%
Molina Mcare Adv	$12,357	88%
Vantage Health Mcare Adv	$12,357	88%
Wellcare Mcare Adv-All Plans	$12,357	88%
First Choice Hie	$15,447	109%
Blue Cross Blue Shield	$15,629	111%
Al Healthcare Adv Mcaid-All Plans	$16,080	114%
Alabama Community Mcaid-All Plans	$16,080	114%
Medicaid / KanCare	$16,080	114%
Univita Healthcare Mcaid-All Plans	$16,080	114%
Molina Chip-All Other Plans	$17,688	125%
First Health-All Plans	$18,720	133%
Geha Ppo-All Plans	$18,720	133%
United Providers-All Plans	$18,720	133%
First Choice-All Other Plans	$19,760	140%
Three Rivers Provider Network-All Plans	$19,760	140%
Vantage Health-All Other Plans	$20,799	147%

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 $20,800.
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 Wayne General 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.