CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: University of Cincinnati Medical Center, LLC

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $26,973
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.91x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at University of Cincinnati Medical Center, LLC is $26,973. 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 1.91x the Medicare baseline. Located in 3188 Bellevue Avenue, Cincinnati, OH.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$26,973

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: $26,973 (191%)

Ins. Median: $26,973 (191% 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	$20,152 - $35,453	143%
Aetna	$20,748 - $34,971	147%
Buckeye Health Plan	$20,748 - $29,048	147%
Devoted Health	$20,748	147%
Humana	$20,748 - $28,010	147%
Medical Mutual	$20,748	147%
Molina Healthcare	$20,748 - $29,048	147%
Paramount	$20,748	147%
UnitedHealthcare	$20,748 - $35,612	147%
Usa Mco	$20,748	147%
Caresource	$20,956 - $26,973	148%
Perennial Advantage	$21,163	150%
Oscar	$22,727	161%
Communicare Advantage	$22,823	162%
Cincinnati Public Library	$39,215	278%
Cronin Automotive	$39,215	278%
Great Parks Of Hamilton County	$39,215	278%
Green Township	$39,215	278%
Health Ohio Network	$39,215	278%
Madtree Brewing	$39,215	278%
Magellan Health	$39,215	278%
Ohio Valley Goodwill	$39,215	278%
Skilled Care Pharmacy	$39,215	278%
Springfield Township	$39,215	278%
Stock Material Handling Systems	$39,215	278%
Watson Gravel	$39,215	278%

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 University of Cincinnati Medical Center, LLC 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.