CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Mary Lanning Healthcare

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $32,380
Cash Discount Price: $34,590
vs. Medicare Baseline: 2.29x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Mary Lanning Healthcare is $32,380. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $34,590. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 2.29x the Medicare baseline. Located in 715 N St Joseph Ave, Hastings, NE.

Cash / Self-Pay

$34,590

Average discount available for prompt cash payment at this facility.

Insurance Median

$32,380

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: $34,590 (245%)

Insurance Median: $32,380 (229%)

Cash: $34,590 (245% of Medicare)

Ins. Median: $32,380 (229% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 229% of the Medicare baseline (a markup of 129%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Tricare	$13,836	98%
Aetna	$14,719 - $33,822	104%
Blue Cross Blue Shield	$14,719 - $32,476	104%
Medica Mcr Adv	$14,719	104%
Ne Total Care Mcr Adv	$14,719	104%
UnitedHealthcare	$14,719 - $73,024	104%
Va Ccn - All Plans	$14,719	104%
Nhn/Mna-All Plans	$31,131	221%
Consociate Inc-All Plans	$32,284	229%
Medica-All Other Plans	$33,437	237%
Provider Network Of America-All Plans	$34,511	244%
Workers Compensation-All Plans	$35,469	251%
Multiplan-All Plans	$36,512	259%
Ambetter / Centene	$38,434	272%
Midlands Choice-All Plans	$69,180	490%

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 $34,590.
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 Mary Lanning Healthcare 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.