CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Sunrise Hospital and Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $11,669
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.83x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Sunrise Hospital and Medical Center is $11,669. 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 0.83x the Medicare baseline. Located in 3186 S Maryland Pkwy, Las Vegas, NV.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$11,669

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: $11,669 (83%)

Ins. Median: $11,669 (83% 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
Molina Healthcare	$1,550	11%
Estudysite	$2,000	14%
Humana	$2,368 - $18,086	17%
Sierra	$2,971 - $3,313	21%
Multiplan	$3,186	23%
Nevada Preferred Professionals	$3,269	23%
First Health	$3,456	24%
Select Health	$3,588 - $28,579	25%
Hometown Health Providers	$3,784 - $4,612	27%
Health Services Coalition	$3,896 - $11,981	28%
Prominence Healthfirst	$4,095	29%
Cigna	$4,327	31%
Aetna	$4,331 - $18,086	31%
Blue Cross Blue Shield	$4,514 - $36,253	32%
United	$5,381 - $17,345	38%
Hometown Health Mcr	$17,512 - $17,544	124%
Alignment Health Plan	$18,053 - $18,086	128%
Ambetter / Centene	$18,053 - $32,555	128%
Triwest Healthcare Alliance	$18,053 - $18,086	128%
Caremore	$18,414 - $18,448	130%
Imperial Nv	$18,956 - $18,990	134%
Universal Healthcare	$19,317 - $19,352	137%

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 $X.
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 Sunrise Hospital and Medical Center 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.