CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Select Specialty Hospital - Cleveland Fairhill

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $1,869
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.13x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Select Specialty Hospital - Cleveland Fairhill is $1,869. 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 0.13x the Medicare baseline. Located in 11900 Fairhill Rd, Cleveland, OH.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,869

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: $1,869 (13%)

Ins. Median: $1,869 (13% 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	10%
Blue Cross Blue Shield	$1,461 - $1,804	10%
Oscar Health Plan	$1,484 - $1,643	11%
Meridian	$1,500	11%
Summacare	$1,500 - $1,600	11%
Ohio Health Choice	$1,507 - $1,641	11%
UnitedHealthcare	$1,645 - $2,558	12%
Phcs Multiplan	$1,700 - $1,800	12%
The Health Plan	$1,745 - $1,869	12%
Ohio State University Managed Healthcare Services	$1,764 - $1,986	12%
Cigna	$1,781 - $2,150	13%
Front Path Health Coalition	$1,839 - $1,950	13%
Ohiohealth Medical Plan	$1,854 - $2,086	13%
Naphcare	$1,951 - $2,229	14%
Cleveland Clinic Employee Health Plan	$2,008	14%
Health Alliance Of The Midwest	$2,125 - $2,609	15%
Medical Mutual Of Ohio-Mmoh	$2,162 - $2,568	15%
Ohio Health Group	$2,213	16%
Health Smart	$2,240 - $2,349	16%
Medical Mutual Of Ohio (Mmoh)	$2,588	18%
Aetna	$2,917	21%

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 - Cleveland Fairhill 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.