CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Lexington Memorial Hospital Inc

Billing Code: 871 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$20,777

about 1.5× the $14,117 Medicare rate · typically $16,507–$26,186

modeled estimate · not a bill or quote

What this hospital charges insurers

$20,073

About the fair price

about $704 under the fair price · 1.4× Medicare

Medicare pays $14,117 Fair price $20,777 This hospital $20,073

How we calculate the fair BaseRate →

How this hospital compares to other NC hospitals

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

Cheapest $13,012 Priciest $20,073

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

A fair price for a Sepsis treatment (inpatient stay) is about $20,777 (about 1.5× the $14,117 Medicare rate). Lexington Memorial Hospital Inc charges insurers about $20,073 — about the fair price. Located in Lexington, NC.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser 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	$11,241 - $20,274	80%
Blue Cross Blue Shieldmajor	$14,370 - $23,080	102%
Aetnamajor	$6,527 - $8,452	46%
Ambetter (Centene)	$14,133	100%
AmeriHealth	$12,344 - $20,073	87%
WellCare	$20,274	144%
+ 6 smaller / regional plans	$20,073 - $20,676

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 Lexington Memorial Hospital Inc 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 Lexington Memorial Hospital Inc

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

Maria Parham Medical Center · Henderson $13,012
Haywood Regional Medical Center · Clyde $13,295
Carteret General Hospital · Morehead City $13,660
Sentara Albemarle Medical Center · Elizabeth City $13,696
Wilson Medical Center · Wilson $14,324
Rutherford Regional Medical Center · Rutherfordton $14,841
Harris Regional Hospital · Sylva $14,955
Ecu Health North Hospital · Roanoke Rapids $15,300

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