CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Person Memorial Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $17,546
Cash Discount Price: $22,549
vs. Medicare Baseline: 1.24x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Person Memorial Hospital is $17,546. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $22,549. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.24x the Medicare baseline. Located in 615 Ridge Rd, Roxboro, NC.

Cash / Self-Pay

$22,549

Average discount available for prompt cash payment at this facility.

Insurance Median

$17,546

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: $22,549 (160%)

Insurance Median: $17,546 (124%)

Cash: $22,549 (160% of Medicare)

Ins. Median: $17,546 (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.

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
Cigna	$1,850 - $17,636	13%
Aetna	$6,401 - $17,376	45%
Tricare	$14,432	102%
Blue Cross Blue Shield	$15,622 - $17,636	111%
UnitedHealthcare	$15,787 - $20,365	112%
Amerihealth Caritas Health Plan	$16,106	114%
Wellpath	$17,376	123%
Devoted Health	$17,546	124%
Advantra	$17,636	125%
Evercare	$17,636	125%
Humana	$17,636	125%
Medicare (plans)	$17,636	125%
Pyramid	$17,636	125%
Secure Horizons	$17,636	125%

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 $22,549.
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 Person Memorial 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.