CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Christ Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $12,716
Cash Discount Price: $30,166
vs. Medicare Baseline: 0.90x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Christ Hospital is $12,716. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30,166. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 0.90x the Medicare baseline. Located in 2139 Auburn Avenue, Cincinnati, OH.

Cash / Self-Pay

$30,166

Average discount available for prompt cash payment at this facility.

Insurance Median

$12,716

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: $30,166 (214%)

Insurance Median: $12,716 (90%)

Cash: $30,166 (214% of Medicare)

Ins. Median: $12,716 (90% 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
Aetna	$10,489 - $29,526	74%
Kentucky Passport/Molina [2097]	$10,489	74%
Medicaid / KanCare	$10,489	74%
Wellcare Of Kentucky [2191]	$10,489	74%
Blue Cross Blue Shield	$12,716 - $30,231	90%
Buckeye Mycare Dual [2171]	$12,716	90%
Cigna	$12,716	90%
Custom Design Benefits - True Cost [3004]	$12,716	90%
Humana	$12,716	90%
Medben [2222]	$12,716	90%
Medicare (plans)	$12,716	90%
Medigold Ppo [2204]	$12,716	90%
Meridian [2185]	$12,716	90%
Other Exchange Plan [9992]	$12,716	90%
Perennial [4200]	$12,716	90%
Poppins Health [2299]	$12,716	90%
UnitedHealthcare	$12,716 - $32,791	90%
Medical Mutual [2054]	$19,897 - $30,612	141%
Allied Benefits [2163]	$29,526	209%
First Health [2041]	$29,526	209%
Meritain Health [2224]	$29,526	209%
Life Synch [2080]	$30,166	214%
Western And Southern [2076]	$30,612	217%
Geha [2168]	$32,791	232%
Golden Rule [2161]	$32,791	232%
United Medical Resources [2104]	$32,791	232%

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 $30,166.
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 Christ Hospital 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.