CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Memorial Community Hospital & Health System

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $10,102
Cash Discount Price: $11,840
vs. Medicare Baseline: 0.72x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Memorial Community Hospital & Health System is $10,102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,840. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 0.72x the Medicare baseline. Located in 810 North 22Nd St, Blair, NE.

Cash / Self-Pay

$11,840

Average discount available for prompt cash payment at this facility.

Insurance Median

$10,102

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: $11,840 (84%)

Insurance Median: $10,102 (72%)

Cash: $11,840 (84% of Medicare)

Ins. Median: $10,102 (72% 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
Blue Cross Blue Shield	$8,868 - $14,208	63%
Humana	$8,868 - $13,320	63%
UnitedHealthcare	$8,868 - $13,320	63%
Medicaid / KanCare	$9,621 - $10,102	68%
Ne Total Care Mcaid-All Other Plans	$9,621	68%
Medica Comm-All Other Plans	$13,468	95%
Multiplan (Phcs)-All Plans	$14,504	103%
Medica Mcr Adv	$18,519	131%
Tricare	$30,711	218%

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 $11,840.
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 Memorial Community Hospital & Health System 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.