CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: The McDowell Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $17,539
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at The McDowell Hospital is $17,539. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.24x the Medicare baseline. Located in 430 Rankin Drive P O Box 730, Marion, NC.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$17,539

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%)
Insurance Median: $17,539 (124%)
Ins. Median: $17,539 (124% 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.

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
United $16,574 - $16,624 117%
Aetna $16,957 120%
Alignment Health $16,957 120%
Devoted Health $16,957 120%
Humana $17,123 - $17,289 121%
Wellcare $17,123 - $23,165 121%
Cigna $17,289 122%
Healthteam Advantage $17,456 124%
Provider Partners Health Plan $17,456 124%
Troy Healthcare $17,456 124%
Apex Health $17,622 125%
Longevity Health Plan $17,788 126%
Nhc Advantage $17,788 126%
Amerihealth Caritas $18,952 - $33,087 134%
Blue Cross Blue Shield $22,491 159%
Vaya Health $23,165 164%
Amerihealth $23,390 166%
Partners Health Management $23,615 167%
Ambetter / Centene $34,950 248%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 430 Rankin Drive P O Box 730, Marion, NC 28752
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals