CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Select Specialty Hospital Youngstown

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $1,751
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.12x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Select Specialty Hospital Youngstown is $1,751. 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 0.12x the Medicare baseline. Located in 1044 Belmont Ave, Youngstown, OH.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,751

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: $1,751 (12%)

Ins. Median: $1,751 (12% 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
Caresource	$1,456 - $1,900	10%
Meridian Health Plan	$1,500	11%
Meridiancare / A Wellcare Company	$1,500	11%
Summacare, Inc.	$1,500 - $1,800	11%
Ohio Health Choice	$1,507 - $1,722	11%
Blue Cross Blue Shield	$1,545 - $1,751	11%
UnitedHealthcare	$1,559 - $1,628	11%
Healthamerica/Health Assurance-Coventry/First Health	$1,618 - $2,028	11%
Naphcare	$1,650 - $2,050	12%
Cigna	$1,662 - $2,030	12%
Bright Health Network	$1,683 - $1,836	12%
Phcs National / Multiplan	$1,700 - $2,300	12%
Ohio Healthy Medical Plan	$1,715 - $2,036	12%
Ohio State University Mhcs, Inc.	$1,721 - $2,048	12%
The Health Plan (Hometown)	$1,745 - $1,869	12%
Healthsmart	$1,869 - $2,349	13%
Healthsmart Complete	$2,240 - $2,500	16%
Medical Mutual Of Ohio	$2,510 - $2,984	18%
Aetna	$3,216	23%

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 Select Specialty Hospital Youngstown 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.