CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Southern Hills Hospital and Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $18,423
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.31x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Southern Hills Hospital and Medical Center is $18,423. 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 1.31x the Medicare baseline. Located in 9300 West Sunset Rd, Las Vegas, NV.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$18,423

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: $18,423 (131%)

Ins. Median: $18,423 (131% 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%
Multiplan	$3,186	23%
Sierra	$3,359	24%
First Health	$3,456	24%
Hometown Health Providers	$3,973 - $4,612	28%
Prominence Healthfirst	$4,095	29%
Health Services Coalition	$4,110 - $11,981	29%
Aetna	$4,574 - $21,674	32%
Blue Cross Blue Shield	$4,697 - $30,190	33%
United	$5,673 - $20,785	40%
Procare Hospice	$18,423	131%
Unified Care Hospice	$18,423	131%
Hometown Health Mcr	$21,024	149%
Humana	$21,024 - $21,674	149%
Alignment Health Plan	$21,674	154%
Ambetter / Centene	$21,674 - $39,013	154%
Select Health	$21,674 - $28,579	154%
Triwest	$21,674	154%
Caremore	$22,107	157%
Imperial Nv	$22,757	161%
Universal Healthcare	$23,191	164%

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 Southern Hills 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.