CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Ohio State University State Health System

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $35,976
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.55x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Ohio State University State Health System is $35,976. 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 2.55x the Medicare baseline. Located in 410 West 10Th Avenue, Columbus, OH.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$35,976

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: $35,976 (255%)

Ins. Median: $35,976 (255% 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 255% of the Medicare baseline (a markup of 155%). 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
Blue Cross Blue Shield	$12,186 - $106,117	86%
Healthspan	$12,186 - $54,413	86%
Medigold	$12,186	86%
Ohio Dept Of Health	$12,186	86%
Upper Ohio Valley	$12,186 - $74,818	86%
Aetna	$12,365 - $91,142	88%
Medicare (plans)	$12,365 - $13,161	88%
Mmo	$12,365 - $36,463	88%
Humana	$12,430 - $31,953	88%
Caresource	$12,983 - $19,166	92%
Molina	$12,983 - $20,650	92%
Buckeye Community	$18,522 - $27,873	131%
Cigna	$29,308	208%
United	$38,641	274%
Osu Health Plan	$43,485 - $56,680	308%
Ohio Ppo	$50,797	360%
Ohiohealth	$73,684 - $82,753	522%
Lifetrac	$77,085	546%
Frontpath	$90,688	642%
Multiplan	$90,688	642%
Healthsmart	$102,024	723%

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 Ohio State University State 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.